Advice for type 2 diabetes patients seeking a healthier, happier lifestyle
For patients with type 2
diabetes, managing the disease can be a burden. However, with medical planning,
diligence and awareness, it may be possible to eliminate the symptoms.
Education is the most important aspect of treatment, as it’s necessary
to understand exactly what your goals are and how to guide your body to
reach them. We spoke with
Maruja Diaz-Arjonilla, MD, a board-certified endocrinology, diabetes and metabolism specialist at
St. Joseph Heritage Medical Group, who navigates the latest research to give us a better understanding of
how patients with
type 2 diabetes might achieve remission.
Q: What does it mean to put diabetes into remission? Is it the same thing
as reversing the disease?
A: In certain cases, intensive medical treatment can put type 2 diabetes
into remission--that is, the right therapies might enable your glucose
levels to remain normal without using diabetes medication. “Reversal”
and “remission" have both been used somewhat interchangeably,
however, "reversal" suggests that the disease goes away permanently.
I prefer the term “remission” because there is always a risk
of relapse--a chance for your symptoms to reoccur if you are not consistent
with treatment or diet and exercise.
If you can maintain normal blood sugar levels for more than one year without
medication, you are in what we would call "complete remission."
Of course, you'll still need regular testing to see if your blood
sugar, blood pressure and cholesterol are in check and to look out for
any problems with your eyes, feet and kidneys.
Successfully achieving remission depends on several factors including the
severity of your case, your genetic background and how long you've
had the disease. Unfortunately, not everyone with type 2 diabetes will
be able to put it into remission, and the best strategy for those people
is to control blood sugar levels and decrease the fat that the body stores.
Q: Could you explain the recent study in the
Journal of Clinical Endocrinology & Metabolism? Should patients be encouraged by these studies or skeptical?
A: You should absolutely be encouraged by the findings in this study. To
sum it up, patients in this study achieved normal
glucose levels – and some even achieved remission - through significant lifestyle
changes like weight loss and medication.
If you're like most patients, engaging in a healthier lifestyle will
allow you to at some point take fewer medications, not to mention the
overall benefits like reducing the risk of heart disease. However, the
idea of no longer needing medications at all should be taken cautiously,
and you must take care to work closely with your physician and follow
the treatment plan that's right for you.
Q: What type of patients might be successful with remission?
A: I think it is possible for almost anyone with type 2 diabetes to attempt
remission, especially if they enter into treatment early in the course
of the disease. This includes women with gestational diabetes--diabetes
that arises during pregnancy. Having gestational diabetes means you are
more likely to develop diabetes in the future, whether or not it disappears
on its own after delivery. If it doesn't go away, you will need to
treat and manage the condition long-term, but you can work with your doctor
to attempt remission as well.
Patients who undergo bariatric surgery--weight loss surgery-- also have a good chance of successful remission. Bariatric surgery is
known to induce type 2 diabetes remission in up to 95 percent of patients.
Because bariatric surgery creates weight loss, the body’s fat storage
is decreased and has a better chance of absorbing sugar into the cells
– resulting in more energy and decreased blood glucose levels. It
also reduces the amount and type of medication needed and improves other
related health issues like sleep apnea and joint pain.
Q: What steps should you take if you're seeking remission?
A: Committing to a very healthy lifestyle and maintaining a healthy weight
is key. You should ensure you are eating nutritious foods and avoiding
things like refined sugar, gluten and alcohol. Opt for high
fiber foods with a low glycemic load, including vegetables, nuts, avocados,
organic meat, fish and eggs. Exercise will also help reduce body fat.
You should generally exercise for at least 150 minutes a week. This lifestyle,
coupled with appropriate medication, will help you on the road to remission.
Keep in mind, you should always consult a doctor before creating or attempting
any kind of remission plan.
Q: Because there is a possibility of remission, does this mean that you
don't have to be as concerned about developing type 2 diabetes or
A: Actually, quite the opposite is true. The possibility of reversal should
motivate you to be more vigilant of the condition and do all you can to
prevent it. You should develop diabetes goals based on your overall health.
Even if you are genetically predisposed, being proactive can help lessen
some of the more uncomfortable symptoms and long-term complications.
In fact, being proactive is the most important piece of advice I can give
when speaking about prevention and management. Being familiar with your
own risk factors, educating yourself and having periodic medical checkups
will have a huge impact on the progression of the condition.
Whether or not you are able to achieve remission for your type 2 diabetes,
I encourage you to find and stick to a treatment plan that will give you
the best possible results. Take charge of your health, and explore your
options with your doctor.
What kinds of diet and exercise work best in managing your type 2 diabetes?
Share a comment below.