Yes and no. More people could become non-diabetic than ever could. Other people really don’t stand a chance. Which one are you?
Before proceeding, what does it mean to become non-diabetic? A simple answer would be to say that your non-medicated fasting blood glucose stays below 126 md/dL and your hemoglobin A1c (average blood glucose) stays within the normal range, and that you are able to eat normal foods.
Many people come close to this definition. Your blood sugar is well controlled – as long as you watch your diet closely. This is then referred to as nutritionally controlled diabetes mellitus.
A major problem with the definition is that the predisposition to diabetes persists in most people who diet to achieve normal blood glucose levels.
A second problem is the underlying etiology of a person’s diabetes. In people with type I diabetes, the pancreas no longer secretes insulin. Without insulin, a type 1 diabetic usually dies within a few days of not receiving insulin. Aside from a pancreas transplant, there is no way to turn a type I diabetic into a non-diabetic at this point in time. Maybe in the future stem cells can be a cure – maybe there’s a way to get a person to grow a new pancreas. Fortunately, type I diabetes is fairly rare compared to type II.
Type II diabetes is usually, but not always, related to weight. With a higher body weight, the pancreas has to release more insulin, but the body in turn becomes resistant to the effects of insulin. Although the pancreas tries harder to keep up with rising blood sugar levels, it eventually loses the fight and blood sugar levels exceed normal levels. In most patients, this condition persists for months to years before a person is diagnosed.
Who can become diabetic? The obese patient who has had diabetes for a relatively short time is the best candidate. Taking medication will Not make you non-diabetic, although it can bring your blood sugar back to normal. However, that doesn’t mean you don’t have diabetes. Stop the drug and your sugar will likely go up.
Although there are occasional exceptions to this rule, the only way to become non-diabetic is to lose a significant amount of weight fairly early in the disease process. A person who has had type II diabetes for a dozen years has likely exceeded 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, if the body is trained early on to use fewer calories, the diabetic process can be reversed. Normally, fasting blood sugar is elevated at this stage, but still below 200 mg/dL. If a patient becomes serious and loses a significant amount of body weight – at least 10% – the process can be reversible. Some patients with higher blood sugar can also become non-diabetic if they lose even more weight—say, 50 to 100 pounds, depending on their starting weight. Once the body stabilizes at the new, lower weight, the pancreas is once again able to keep up with the body’s insulin needs.
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 the medication. If your weight goes down, the drug can be tapered off.
If you are overweight and have been diagnosed with diabetes in the last few months (or maybe even a few years ago). Serious and lose weight. The same advice applies to anyone in the prediabetic phase. Act now before you are diagnosed with an illness that could haunt you for the rest of your life.
Copyright 2010 Cynthia J Koelker, MD
Thanks to Cynthia Koelker
