Type 2 diabetes remission is defined as achieving specified glycated hemoglobin (A1C) thresholds under 6%, and this without any diabetes medication for at least 3 months.
Diabetes remission does not mean diabetes recovery.
The remission of diabetes is, in most cases, temporary. Therefore, it involves a possible relapse, which means a type 2 diabetes come back after several months or years. It is called a relapse when your hemoglobin A1C, or HbA1c, reaches 6.5% or more again, or when you have to take medication again to manage your diabetes or its complications.
Type 2 diabetes remission is considered by some people to be another treatment option in their diabetes management and its complications. However, it is not a diabetes remedy.
Who can try a type 2 diabetes remission?
Diabetes remission is not for everyone. There is currently no success indicator.
Achieving remission is more likely for individuals:
- Recently diagnosed with type 2 diabetes, that is to say, less than 6 years
- With overweight or obesity, who are able and inclined to lose weight
- With blood glucose levels that are not that elevated
- Who do not take insulin
For some people it is strongly recommended not to go through type 2 diabetes remission, it concerns people who:
- Show diabetes complications
- Live with an eating disorder or a mental health condition.
How to go into remission from type 2 diabetes?
Remission periods are mainly seen in a significant weight loss situation, that is to say more than 15 kg (33 lbs).
There are currently three methods:
1. Bariatric surgery
It is the most efficient approach. It however needs a surgical intervention which is irreversible and likely to have a higher rate of complications. It concerns people with a body mass index (BMI) above 35.
With this method, between 30 and 60% of people were in remission after 5 years. And less than 50% were still in remission after 8 years.
2. Low-calorie meal plans through the intake of liquid meal alternatives.
It is a method based on a restrictive and low-calorie diet. For about 5 months, meals are made of only 1 to 2 broths or an alternative to liquid meals (such as Glucerna®, Boost®, Optifast®). It is followed by a progressive food reintroduction for 1 to 2 months. Calories in the diet are still monitored and adding physical activity is strongly recommended to keep a steady weight. Meal alternatives could also be reintroduced in case of weight gain.
With this method, 50% of people were in remission after 1 year. And 1 in 3 people were still in remission after 2 years.
3. A physical activity program combined with a low-calorie diet.
This method lasts between 4 to 12 months and contains:
- Physical activity for 30 to 60 minutes, 5 to 6 days a week
- A low-calorie diet.
With this approach, 1 in 4 people were in remission after 2 years.
Benefits of remission
There are no real studies showing that type 2 diabetes remission has benefits on health.
But it has been recognised that an improvement of HbA1c and weight loss reduces diabetes complications and insulin resistance.
Warning
Before you go into remission, it is important that you have an in-depth discussion with your care team on the related risks and benefits of remission. An examination should also be done.
The agreement in the attempt of diabetes remission is based on an important and long commitment which can lead to a negative impact on your self-esteem if you do not reach remission or in case of relapse.
While attempting remission, it is essential to be surrounded by medical professionals. Follow-up and adaptations will be made all along the process to ensure a safe progress.
If your remission is successful
Blood tests will have to be done in the 6th month to ensure that there is no diabetes relapse. Even with a successful remission, you should prioritise a healthy lifestyle and check on your blood pressure and cholesterol.