Dr. Ahmed
Can You Get Rid Of Diabetes? Yes and No.
Yes, if you have developed diabetes because of your diet, lifestyle, medical conditions, or the drugs you are taking.
No, if you have diabetes type 1, have a strong family history of diabetes, and you developed diabetes despite being very cautious about diet and health.
Yes, if you are overweight or obese and planning to undergo a bariatric/ cardiometabolic surgical weight loss procedure or on the latest class of medications, Ozempic, Jardiance, or Mounjaro.
No, if you are on insulin, sulfonylureas, or other Beta-cells depleting drugs.
Introduction:
Diabetes is a chronic metabolic disorder. Over the last couple of decades, the number of diabetic patients has doubled.
The question which is the need of the hour and mostly asked is whether diabetes can be cured or not.
The answer to this is very complex because diabetes is not just in your genes, it is also because of how your body responds to what you eat, how frequently you eat, how you exercise, your medical conditions, your body stress level, and how you cope up with stress, and many more factors.
You can delay the onset of diabetes if you consume a low-calorie diet, exercise regularly, and maintain your body weight in the healthy range.
What Is Diabetes And How Does It Occur?
Diabetes is a state of high blood sugar in your blood. Normally, what you eat is managed by your body so well that the blood sugar does not rise above 100 mg/dl in the fasting state and above 140 mg/dl in the post-meal (prandial) state.
However, diabetes develops when there is either insufficient insulin as in people with type 1 diabetes or the body does not respond properly to insulin (insulin resistance) as in type 2 diabetes.
There are many different types of diabetes, however, in general, two types of diabetes, type 1 and 2 are the most common.
Insulin Dependent Diabetes Mellitus (IDDM) Type 1 and Type 2
In type 1 diabetes, the body is unable to produce insulin. In contrast, type 2 diabetic patients either produce less insulin than normal or the body sometimes develops insulin resistance resulting in a decreased response of insulin to transfer glucose into the cells.
The other forms of diabetes are gestational diabetes which occurs during pregnancy, LADA, or types 1.5 diabetes, MODY (maturity-onset diabetes of the young), secondary diabetes, type 3c diabetes, and many more.
Diabetes has also been recently divided into five different groups based on a patient’s characteristics and the risks of developing diabetes-related complications. These 5 groups are:
- SIDD (severe insulin-deficient diabetes)
- SIRD (Severe insulin-resistant diabetes)
- SAID (Severe autoimmune diabetes)
- MAD (Mild age-related diabetes)
- MOD (Mild obesity-related diabetes)
The first three types resemble those of type 1 and type 2 diabetic patients who develop complications while the last two forms are usually milder forms of diabetes. These patients may not develop any complications related to diabetes.
MRDM (Malnutrition-related Diabetes Mellitus): Definition, Criteria, Diet
Can you get rid of Type 1 Diabetes?
After malignancies and cardiovascular disorders, autoimmune diseases are the third most common type of sickness in developed nations.
10 million people worldwide suffer from type 1 diabetes, often known as autoimmune diabetes. Insulin insufficiency, hyperglycemia, and complications are induced by the autoimmunity-mediated death of pancreatic beta-cells in this illness.
Type 1 diabetes usually affects children and people in their younger ages. It starts all of a sudden or is triggered by acute stress or illness.
Type 1 diabetes patients have relative or absolute insulin deficiency and people require insulin to manage their hyperglycemia. Without insulin therapy, these patients can go into DKA, a life-threatening complication of type 1 diabetes.
How is diabetes type 1 treated?
The only treatment for diabetes type 1 is insulin therapy. Insulin treatment is life-saving in patients with type 1 diabetes.
Diabetes is typically treated with regular insulin replacement by injections or, occasionally, insulin pumps. Insulin from outside the body is what is referred to as exogenous insulin.
Research on insulin replacement typically focuses more on enhancing current therapies than on finding a cure for type 1 diabetes. But they can make a big difference in terms of quality of life.
Novel insulin analogs are being formulated to reduce the number of injections per day. Little progress has been made as to how to get rid of diabetes type 1.
Artificial pancreas and Beta-cell transplantation seem the only options to get rid of diabetes type 1.
Pancreatic Beta Cell Transplantation to get rid of diabetes type 1:
This type of method can ensure normal levels of glucose in the body for a lengthy period of time.
According to a study, this method is effective & safe too as shown by the clinical outcomes, it has a tendency to ensure normoglycemia in patients with type 1 diabetes mellitus. This technique works effectively in restoring the glucose’s physiological metabolism in the body. [Ref]
In a 2019 study, it was concluded that the use of monoclonal antibody treatment, in individuals who had not been diagnosed with diabetes but had a high risk of developing the condition, could possibly delay the onset of the disease. [Ref]
Isolated Islet cells transplantation to get rid of diabetes type 1:
Compared to pancreatic Beta-cells transplantation, islet cells also contain alpha cells and other cells.
Successful transplantation of isolated pancreatic islets results in stabilization of blood glucose levels and might even achieve temporary freedom from external insulin. [Ref]
Since islet cells are not the patient’s own cells, patients who undergo this procedure have to take immunosuppressants for the rest of their lives to avoid rejection.
Can you get rid of diabetes type 2?
There is a difference between cure and remission. Most experts think that you can help a diabetic patient go into disease remission but you can not cure diabetes.
Curing is a completely normal person who responds normally to abnormal diets and sedentary lifestyles. Remission is achieved with a low-calorie diet, exercise, and surgical or non-surgical weight loss methods.
Once a diabetic person who is in remission moves away from a healthy low calorie diet or exercise, his blood sugars may rise again.
Insulin Dependent Diabetes Mellitus (IDDM) Type 1 and Type 2
Thus, remission is a temporary achievement controlled by constant efforts while a cure is a complete remission where a person can deviate from his normal diet and still have his blood sugars within the normal ranges.
Complete remission is when the blood glucose is within the normal range while partial remission is when the blood glucose is in the prediabetes range.
Following are the ways that will help you achieve remission.
Physical Activity:
Diabetics need to secure 150 minutes of multiple sessions of workout on a weekly basis or a minimum of 30 minutes daily.
It is better to start slowly. Do not try to overwork yourself and start lifting heavy weights, rather than that, try to start walking on a daily basis and work your way towards running every day.
Keep a check on your glucose levels to avoid any spikes and hypoglycemia in case of which you must keep a light snack with you at all costs.
For beginners, light activity is sufficient but for those who aim to cure diabetes, high-intensity-interval training (HIIT) and aerobic exercises are important. These exercises must be tailored as per the person’s tolerance and the goal weight to lose over 3 to 6 months.
It has been estimated that a loss of 10% of a person’s body weight is associated with marked improvement in the complications associated with obesity including diabetes.
However, for curing diabetes type 2, more than 10% weight loss is recommended.
Lose The Unwanted Pounds:
Now weight loss is exactly the focus here. Moments after diagnosis, one must start one’s weight loss plan and stick to it.
There are people who have experienced remission after almost 25 years of being diagnosed. Obese people experience a more frequent remission if they lose a significant amount of weight, e.g., 15 kg of weight. [Ref]
It’s crucial to understand that not everyone who loses this much weight can put their diabetes into remission. Even if it doesn’t result in remission, dropping 15 kg has a lot of positive health effects.
Even only 5% weight loss can lead to fewer complications, better control of glucose levels, and fewer medicines.
Weight loss exceeding 10% of the body weight is difficult to achieve with exercise and a low-calorie diet alone. One may benefit by taking weight loss medicines that are very potent and result in significant weight loss such as Saxenda, Wegovy (or Ozempic), and Tirzepatide (Mounjaro).
Wegovy vs Sleeve Gastrectomy: Weight Loss Medicine Vs Surgery
For morbidly obese people who fail to lose weight despite all their efforts, bariatric surgical procedures like LSG (laparoscopic sleeve gastrectomy) and Gastric Bypass may be the best option.
Other options may include endoscopic gastric bypass (Endobarrier method) and weight loss balloon for people who are not surgical candidates.
Weight Loss Balloon and Endoscopic Weight Loss Interventions
With LSG and gastric bypass, the remission rates of diabetes (diabetes cure rates) are very high approaching almost 80%.
In addition to curing diabetes, bariatric surgical procedures also improve other obesity-associated medical conditions like sleep apnea, hypertension, hyperlipidemia, and cardiovascular diseases.
From the chart shown above, it is obvious that LSG results in diabetes remission or cure in 81% of patients, and improvement in diabetes is seen in 11% of the patients (totaling 92% of the patients).
Healthy Diet:
When talking about weight loss, a healthy diet is what keeps you grounded. A healthy diet can have multiple meanings in this case.
Considering that it can aid in weight loss, some people advise type 2 diabetics to follow a ketogenic diet. Though, research says otherwise, the ketogenic diet is not shown to be healthy for everyone. [Ref].
Some people adhere to a low-carbohydrate diet, which limits their daily consumption of carbohydrates to 130 grams, or 26% of their total daily caloric intake. [Ref]
Currently, the best way to manage your weight while taking care of your diet is to consult a nutritionist or a dietician who will help you craft a meal plan that goes well with your metabolic needs.
The main aim of a diabetic diet is to follow a diet that results in a calorie deficit and contains all the nutrients including vitamins, minerals, and macronutrients.
