Beating type 2 diabetes into remission

Abstract

Remission of diabetes (no longer having diabetes, at least for a period) is clearly attainable for some, possibly many, patients but is currently very rarely achieved or recorded. Greater awareness, documentation, and surveillance of remissions should improve health outcomes and reduce healthcare costs.

Reversing disease

“…If weight gain causes type 2 diabetes in susceptible individuals, would weight loss reverse the disease? A recent analysis in the BMJ [2] would suggest that it can.…”

“…Louise McCombie and her colleagues [2] from the University of Glasgow, Scotland, point out that type 2 diabetes is generally regarded as progressive and incurable. In the UK alone this disease now affects 5 -10% of the population.…”

“…[4] We now know that one of the main reasons for the pathology is the accumulation of ectopic fat in the liver and pancreas that impairs organ function, and that reversing this accumulation reverses the disease. McCombie et al [2] suggest that a simple approach to classifying remission as two normal tests (either blood glucose or HbA1c) at least 2 months apart and regular annual follow-up should be sufficient to diagnose 'remission' .…”

“…In Scotland, for example, results that included every patient in Scotland with diabetes showed that <0.1% of those with type 2 diabetes were coded as being in remission in March 2017. McCombie et al [2] suggest that the main reason for this is that neither patients nor their doctors are focusing on trying to achieve remission. Indeed, they may be unaware that this can be achieved.…”

Diabetes and travel insurance costs: let's talk about remission

“…Recent research has shown that type 2 diabetes need not be a permanent condition, and that remission from the disease is possible following substantial weight loss . In recognition of this, the clinical coding system routinely used across UK health care has a specific code for those who successfully achieve and meet the criteria for diabetes remission . While long‐term outcomes have yet to be established, there seems little doubt that having an HbA 1c in the non‐diabetic range is likely to herald reduced long‐term vascular risk and justify lower travel insurance premiums …”