Is Type 2 Diabetes Reversible?
Type 2 diabetes is characterized by the impairment of the body to regulate and use glucose (sugar) as fuel. Because of this, there may be too much sugar in the bloodstream and not enough going into the tissues that need the glucose. The reason behind type 2 diabetes is that the pancreas does not produce enough insulin, which is the hormone responsible for taking glucose away from the bloodstream and delivering it into the cells. Additionally, in type 2 diabetes, cells become more resistant to insulin and are able to take in less sugar.
Type 2 diabetes is also known as adult-onset diabetes, different from type 1 diabetes, which is more common during childhood or adolescence. Type 2 diabetes has causes most attributed to lifestyle as risk factors include obesity and inactivity, but other risk factors include family history, ethnicity, blood lipid levels, age, and fat distribution.
A healthy lifestyle is important in helping to prevent type 2 diabetes. This includes eating a healthy diet that is low in fat and higher in fiber, with vegetables, fruits, and whole grains in every meal. Additionally, exercise is important with moderate to vigorous aerobic activity, which includes going for a walk, cycling, or swimming.
Type 2 diabetes is most commonly diagnosed with a HbA1c test, which is a blood test that measures the three month average of glucose attached to hemoglobin. Below 5.7% is normal, while 6.5% or higher is indicative of diabetes. This test is also used to monitor the management of existing diabetes
But what if you have already been diagnosed with type 2 diabetes?
Treatment for type 2 diabetes is personalized and may be different for everyone. Doctors may prescribe a non-insulin medication, usually metformin, along with encouragement to maintain a healthy diet and exercise to control blood sugar levels. Metformin works by increasing the body tissues sensitivity to insulin, decreasing the absorption of sugar, and lowering sugar production. However, medication is not enough to manage type 2 diabetes and lifestyle changes must be made.
Many studies have shown that type 2 diabetes may be reversible but other studies have shown that it can go back if management with lifestyle changes are stopped.
Case study:
Patient at a community health center aged 30-40 diagnosed with type 2 diabetes. HbA1c results were 6.7%-7.0% at diagnosis and the patient was started on metformin and encouraged to make changes in their diet and lifestyle, with lower calorie intake and at least 3 hours of moderate to vigorous aerobic exercise a week. Their condition was monitored every 3 months with HbA1C blood tests. Patient reported compliance with medication regime and major changes in lifestyle including exercise and diet. After 9 months, HbA1c results were below 5.5% a level seen in non diabetic patients.
Although inspiring, patients that achieve this are rare as major lifestyle changes are difficult to make and stick to. Those that make those changes are able to avoid the severe consequences of the disease progression of type 2 diabetes. However, be advised that reverting back to an unhealthy lifestyle may elevate blood glucose levels again and reduce sensitivity of the body to insulin.
Sources:
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
https://medlineplus.gov/druginfo/meds/a696005.html