Remission is an important goal in type 2 diabetes


Robert A. Gabi, MD, Ph.D.

Diabetes is one of the biggest health threats in the United States. more than 37 million Americans live with Type 2 diabetes, which makes up more than 11% of the US population. Even more alarming is the increasing rise in both diabetes and prediabetes: 38% of adults have prediabetes and 1.4 million Americans are diagnosed with diabetes every year. At the American Diabetes Association (ADA), we’re laser-focused on what we can do to change these astronomical numbers.

Fortunately, many companies and health plans are working aggressively to reduce diabetes among their population. As diabetes has gained a greater position in the benefits community, we have seen an increase in reference to ‘diabetes reversal’. To understand the appeal of such an outcome, it is important to consider the physiological nature of the disease itself as we work together to mitigate its severity.

To be clear, “reversal” of diabetes is not recognized by the ADA or the endocrinologist community as a legitimate condition of diabetes. In a best-case scenario, “quiet” is a more accurate description of what people diagnosed with type 2 diabetes can achieve. Similar to the way the medical community refers to cancer remission when treatment is successful, we must use the correct term to define disease status—if for no other reason than to manage expectations about possible disease return and the constant need for screening. to the development of complications.

People with type 2 diabetes are considered to be in remission after maintaining normal blood sugar levels (A1c <6.5%) for at least 3 months without taking diabetes medications. Note that the ADA specifies metformin As a diabetes drug, regardless of any other potential uses.

Diabetes remission, not reversal

The claim to reverse diabetes is a shaky foundation. It ignores the progressive nature of the disease. Once a person develops type 2 diabetes, they will always have a tendency to develop the disease. People can achieve remission through healthy eating, restricting carbohydrates, and other means, but the underlying physiology of diabetes cannot be reversed at this time. The term “reflection” presents a particular problem when used to describe people who just barely cross a threshold A1c 6.5% and may easily become symptomatic again. The human body is so complex and so complex that even the slightest transformation can push a person back into the state of diabetes.

even after Bariatric surgeryIt is well established to be an effective treatment for people with type 2 diabetes and obesityThe medical community agrees that only forgiveness is possible. It appears that type 2 diabetes Recur 3-15 years after surgery In 30%-50% of patients initially experienced postoperative remission. If a person lets their diet break down and/or regains their weight, the symptoms of diabetes will reappear.

Another reason the term “reversal” is a problem is that it can lead people to believe they have outgrown the disease. In fact, continued recovery requires continued adherence to a diabetes prevention program. After medications are no longer needed, a person may still need to maintain a nutrition plan, fitness regime, and mental health care. If this person abandons their dietary watch and regains their weight, the symptoms of diabetes will recur. This is why diabetes is considered a chronic condition.

People with diabetes must be constantly monitored and supported for successful diabetes management. For those in recovery from diabetes, subsequent tests should be performed at least annually to determine this Long-term maintenance And make sure they stay below the A1c threshold. Even in recovery, people with diabetes should have routine tests for possible complications of the disease.

The task of prevention and treatment type 1 diabetes Improving the lives of all people with diabetes remains a top priority in ADA’s research programs. Each year, the ADA brings together the diabetes community to deliver the latest innovations, prevention and care. This summer, in The 82nd Scientific Sessions of the ADAWe’ve seen research showing that Artificial intelligence Offers significant remission rates for type 2 diabetes.

We welcome the medical and technological innovations made over the past two decades. As a result, people with diabetes live healthier and fuller lives, and the drive to reduce its prevalence is a common goal of many healthcare organizations and companies nationwide.

The only way to reduce the prevalence of diabetes is by working together as a healthy community for a better tomorrow. This also means that we cannot allow the clinical definition of reversal to be used in a convenient manner. By using the correct term “remission” for type 2 diabetes, we hope to emphasize the importance of adhering to long-term management practices, such as healthy eating, exercise, mental health care, and regular checkups to keep you calm – an achievement to be proud of and maintain.

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