Yes and no. More people may become antidiabetic than ever did. Other people really don’t stand a chance. Which one are you?
Before continuing, what does it mean to stop being diabetic? A simple answer would be to say that without medication, your fasting blood sugar remains below 126 md / dL and your hemoglobin A1c (average blood sugar) remains in the normal range, and that he can eat normal food.
Many people come close to this definition. Your blood sugar levels are well controlled, as long as you closely monitor your diet. This is called diet-controlled diabetes mellitus.
A big problem with the definition is that the tendency to diabetes persists for most people who achieve normal blood sugar levels through diet.
A second problem is the underlying etiology of a person’s diabetes. For type I diabetic patients, the pancreas no longer secretes insulin. Without insulin, a type I diabetic will usually die within a few days of not receiving insulin. Other than a pancreas transplant, there is no way to stop a Type I diabetic from being diabetic at this time. Perhaps in the future stem cells can provide a cure; perhaps there is a way to make a person develop a new pancreas. Fortunately, type I diabetes is quite rare compared to type II.
Type II diabetes is often related to weight, although not always. With a higher body weight, the pancreas has to secrete more insulin, but in turn the body becomes resistant to the effects of insulin. Although the pancreas tries harder and harder to keep up with rising blood sugar levels, it eventually loses the battle and blood glucose levels exceed normal values. In most patients, this condition persists for months or years before a person is diagnosed.
Who can become antidiabetic? The overweight patient who has had diabetes for a relatively short period of time is the best candidate. Taking medications no make you not diabetic, although it can bring your blood sugar back to normal levels. However, that doesn’t mean you don’t have diabetes. Stop taking the medicine and your blood sugar will likely go up.
Although there are occasional exceptions to this rule, the only way to become antidiabetic is to lose a significant amount of weight fairly early in the course of the disease. A person who has had type II diabetes for a dozen years has probably outgrown the body’s ability to restore normal pancreatic function. The pancreas wears out, less and less, and just can’t keep up, like a failing heart.
However, early in the process, if the body is retrained to use fewer calories, the diabetic process can be reversed. Usually at this stage, fasting blood sugar levels are elevated, but still below 200 mg / dL. If a patient becomes serious and loses a good amount of body weight (at least 10%), the process can be reversible. Some patients with higher blood sugar levels can also become antidiabetic if they lose even more weight, say 50 to 100 pounds, depending on the starting weight. Once the body stabilizes at the new lower weight, the pancreas can again meet the body’s need for insulin.
Along the way, your doctor will likely prescribe medication. It takes time to lose weight, and you shouldn’t wait 6 to 12 months to start taking medicine. As you lose weight, you can gradually reduce the medicine.
If you are overweight and have been diagnosed with diabetes in the last few months (or maybe even a few years ago) be serious and lose weight. For anyone in the prediabetic phase, the same advice is valid. Act now before you are diagnosed with a disease that can haunt you for the rest of your life.
Copyright 2010 Cynthia J. Koelker, MD
