World Diabetes Day 2022: Doctors on tips to become diabetes-free and achieve remission
While there is no treatment for type 2 diabetes, research indicates some people may effectively reverse the condition. Follow these tips to achieve diabetes remission.
Diabetes is one of the fastest growing chronic diseases in the world and changes the life of a person suffering from it in many ways. There is no cure for diabetes so far and once diagnosed a person has to work towards managing their blood sugar levels every single day with the help of medication, insulin and lifestyle changes. Failure to keep your glucose levels in check could put one at risk of several diabetes complications that may affect liver, kidney, heart, eyes, skin and basically every part of your organ. Uncontrolled blood sugar is thus deadly and people suffering from it are constantly under pressure to manage the disease for a healthy life. While diabetes has no cure and the medication is just to control symptoms, in some people diabetes remission (scientific name for diabetes reversal) is possible. (Also read: Diabetes: Warning signs of high blood sugar that appear on skin)
"Despite the fact that there is no treatment for type 2 diabetes, research indicates that it is feasible for some people to reverse the condition. One may be able to reach and maintain normal blood sugar levels (also known as blood glucose levels) without the need of medication by implementing some adjustments. This is potentially life-altering," says Dr Niranjan Singh, Senior Internal Medicine Specialist & Diabetologist, Shalby Multispecialty Hospitals Jaipur.
What is diabetes remission and how we can achieve it
According to studies, diabetes remission is defined as having a HbA1c of less than 6.5% (i.e., at the pre-diabetes stage) without the use of medicines and insulin for at least six months. This concept of reversing diabetes is a novel one.
"In lay man terms reversing diabetes means moving from a stage of diabetes to prediabetes all the way back to normal. Is this possible? Yes, it is possible in some people. Remission is the correct terminology used for reversal of diabetes. There are many other names as well but scientifically correct terminology is called remission. It means reversing diabetes and it is defined as having a Hb1ac of less than 6.5 for a period of at least 3 months without medication. If the patient is able to achieve this, then it is termed as diabetes remission, says Dr R. M Anjana - Managing Director and Consultant of Dr Mohan's Diabetes Specialities Centre and Vice- President of MDRF
"A substantial amount of advanced research is required before we can fully comprehend it. We lack sufficient evidence to conclude that remission is durable. It must be maintained, and in many cases, blood sugar levels might rise again, which is why it is crucial to maintain your diabetes appointments even if in remission," says Dr Singh.
"Diabetes remission can be achieved with low calorie diet. People can reduce the calories below 1000 calories a day for a longer term and that has been seen in the studies in England and found that many people could achieve diabetes remission after that," says Dr Mahesh Chavan, Consultant, Endocrinologist and Diabetologist, Apollo Hospitals Navi Mumbai.
"The other way is to increase physical activity where people can aim for 10000 steps a day or at least 2 and half hours of moderate exercise per week along with cutting 500 to 750 calories a day," Dr Chavan adds.
Once you have achieved diabetes remission, you should try to keep the disease away.
Dr. Niranjan Singh talks in detail about the methods that can be used to sustain diabetes remission:
Low-calorie diet
Weight loss seems crucial. Sometimes decreasing weight can help you live diabetes-free, especially if you've had the disease for a few years and haven't needed insulin. Several studies have examined how a low-calorie diet affects diabetes. It involves working with a specialist and monitoring one's calories. The possibility of remission may motivate you to continue. People who drop weight have less fat in their liver and pancreas, which help the beta cells produce insulin and manage blood sugar. After being diagnosed, you should start a weight loss plan immediately.
Exercise
Diabetes can be improved by increasing physical activity, but it may be difficult to reduce enough weight to achieve remission by exercise alone. However, exercise is beneficial when coupled with dietary adjustments. A modest, low-calorie diet combined with a significant increase in physical expenditure could put you on the road to remission.
Fasting
Fasting is a simple approach to lose weight, but it's not a mainstream cure for type 2 diabetes. A brief study indicated therapeutic fasting can reverse type 2 diabetes. Several studies suggest intermittent fasting's health benefits. Intermittent fasting improves chronic illness control in humans, but these studies take months. It's also uncertain if the diet's benefits would last a lifetime. One can consult their doctor if they wish to fast safely.
Bariatric surgery
This surgery helps you lose weight by limiting what you can consume. Scientists don't know underlying reasons, but losing weight enables to reverse diabetes. Some believe it changes the gut hormones to help manage blood sugar. Generally, bariatric surgery is only a possibility for those with a Body Mass Index (BMI) of 30 or over. It is most effective for individuals with diabetes who have not used insulin for at least five years. If you have recently been diagnosed with obesity, this is something to discuss with your physician. There can be risks to this, however, the majority of diabetics who undergo this treatment experience remission.
Medical Nutrition Therapy
Medical Nutrition Therapy (MNT), coupled with current medical approaches to treat chronic disorders, is changing how diabetes is handled globally. The ADA-EASD Consensus Report supports patient-centred care that considers health history, weight, care costs, and food preferences. MNT has a higher adaptation or beneficial influence on pre-diabetics (those without normal blood-sugar levels but are not diabetic). MNT was created to offer a systematic strategy to managing diabetes, however, there are concerns about the availability of nutrition experts who can construct tailored diets for each patient, as each diabetic has distinct symptoms, preferences, and co-morbid illnesses.
"Research investigations are expected to transform the clinical approach to type 2 diabetes around the world, so medical experts can combine early screenings with lifestyle treatments to get rid of the problem immediately, rather than placing individuals on many prescriptions for life. Diabetes reversal is emerging, but reversal strategies are still being developed. Analysing research to determine patient-centric parameters to reverse diabetes in clinical practise is significant. Come what may, advanced research is vital," concluded Dr Singh.
