Dr.
V Mohanin this time from a quick diet and weight loss program, the reversal diabetes has become a topic of heat discussion, especially on social media platforms.
While the reversal is possible for some people with type 2 diabetes, type 1 diabetes is not reversible.
However, there are many aspects about diabetes reversal, which people don’t realize.
The following is the case at the point.
One of my patients, a 35-year-old man, had diabetes for six years.
At first we treated it with tablets along with insulin because of its very high sugar levels.
We put him on low calories, a low-carbohydrate diet, the following whose weight is reduced from 123kg to 99kg (24kg weight), for two years.
He reached his diabetes remission.
His HBA1C declined from 8.4% to 5.4%.
The fasting sugar levels dropped to 83 mg / dl and postprandial sugar 110 mg / dl.
All drugs antidiabetes are stopped.
He then went around told everyone he ‘recovered’.
He refused to come for further check-up.
He returned to eat without restrictions.
After nine months, he felt unwell and returned for a review.
He has obtained 13kg.
Hba1c had shot up to 9.6% and his blood sugar became 321 mg / dl.
He must restart all of his diabetes drugs.
Diabetes ‘re-reversal’ has occurred.
I have seen a large number of people like those who have tried a variety of FAD diets and reversal programs, whose diabetes are now worse than when they start this routine.
In the natural history of type 2 diabetes (as shown in the graph), there is a stage of normal glucose tolerance, followed by the pre-diabetes stage and finally, diabetes.
This development is known.
Less famous is the fact that some people can also move in the opposite direction – pre-diabetic and normal diabetes.
According to the American Diabetes Association, the correct term for ‘reversal’ diabetes ‘remission’ diabetes.
Even though they are used alternately, there are subtle differences in the sense.
Reversal implies diabetes will never return.
Because this is rare, this term remission.
This is similar to cancer entering the remission.
There are several treatment options to achieve diabetes remission.
One of them is through modification of lifestyle usually through a low-calorie diet (around 800 calories / day).
This will produce a negative calorie balance and cause a rapid weight loss.
Low carbohydrate diets (less than 10%) are also widely used.
The problem with a low carbohydrate diet is that it will greatly increase the fat content of the diet that can increase the evil (LDL) cholesterol and thus increase the risk of heart disease.
In addition, a low-carbohydrate diet is rarely sustainable in our country.
Recovery using technology various technologies currently used, to try reversal.
The most common is to use a cellphone or coach or diabetic educator, which continues to deal with people and motivates them to achieve weight and sticks to modify their lifestyle.
There are various applications used for this purpose that calculate steps that take per day and / or calories in the diet and provide constant feedback for people to help achieve remission diabetes.
The problem is that there are many hype, and false claims are made.
In most cases, remission occurs due to deep weight loss.
If people get back weight, as they usually do, diabetes always comes back, often with all my heart.
While some of my patients have maintained remission for several years, in diabetes the people who come back and they need to take medicine again.
Long-term sustainability is thus a problem with a reversal program.
Re-reversal is a reality.
Therefore, it is important for those who have achieved remissions to maintain weight and continue diet and exercise.
The most important thing, routine visits to the doctor is a must, because it is very important to continue to monitor one’s health.
This is a mistake to assume that one is ‘recovered’.
It doesn’t matter if you don’t reach remission.
Some of my patients have celebrated their 100th birthday despite having diabetes for 60 or 70 years and have continued their medicine for life.
Keeping diabetes under control and going for routine checks is the key to long and healthy life even though diabetes.
(The author is the Chair and Diabetologist Consultant at Dr.
Mohan, this Diabetes Specialties Center, Chennai) Email your response with the name and address to Southpole.toi@timesgroup.com