Incurable?

[Shel_B]

A recent article in one of the news magazines -Newsweek, IIRC - mentioned that a morbidly obese woman had lost a lot of weight and improved her health sub stantially. The article went on to say that her diabetes had been "cured."

Comments on this forum have suggested that diabetes is not curable, and that it can only be regulated. So, in consideration of the Newsweek article, could someone provide a pointer to a citation or an article that describes how diabetes in incurable, specifically Type 2 diabetes where there is some degree of insulin still being produced.

Thanks!

shel

[JediSkipdogg]

Shel, I've asked that million dollar question before and I disagree with many.

In theory, if the entire US gained 600 lbs overnight I bet within 30 days most (90%+) would be diabetic as the pancreas couldn't support that extra weight and insulin production. If they then all lost the weight a month later would they be cured or still diabetic? So wouldn't they all be undiagnosed diabetics now?

The same could be said about cholesterol. If I eat McDonald's 3 times a day my cholesterol will most likely go up. If I stop eating there am I cured?

It's a question of what do you consider cured....

[fgummett]

How do you define "cured"?

[Tribbles]

The term normally used is remission rather than cured but it is possible. The success rate varies between 60 and 90% according to who you read. A lot of the papers are funded by organisations that have an interest in selling the surgery so beware. I am not sure if there has been any long term follow up (the average seems to be a year) as it would be interesting to know what happened over a five and ten year time span.

The key things for success seems to be earlier intervention and the mildness of the diabetes. Intervention within five years and for diet controlled diabetes looks pretty good. There is no certainty that it won't reoccur (hence remission rather than cure) but it seems that if it does it will likely be for other reasons.

[Larry H.]

It does bring into question some of the long held theories or research as to the causes, and conditions of diabetes to me. Like how can something where told for the most part that the pancreas has stopped functioning or if it hasn't one day will. How can all of a sudden that not be so? ( I may have the technical parts wrong but I am sure you will get the gist)

[Moonglo]

My doctor said that I could "reverse" my t2 by eating right, exercising, losing weight, and taking my metformin, at which point I would be able to control it with diet and exercise alone. While that may mean I wouldn't have to check my bg every day, and that I could eat a little less restrictive of a diet, I don't think I'll ever be able to go back to my old ways of eating altogether, because then I'd be putting my body through the same stresses I did before and I might get right back to where I am now. So, as others have said, in my mind it really depends on your definition of "cure."

[Tribbles]

It does bring into question some of the long held theories or research as to the causes, and conditions of diabetes to me. Like how can something where told for the most part that the pancreas has stopped functioning or if it hasn't one day will. How can all of a sudden that not be so? ( I may have the technical parts wrong but I am sure you will get the gist)
The problem is that type 2 diabetes is heterogeneous, there are several causes which are present in varying permutations. The case we are talking about here is where the person is carrying so much weight that their beta cell function is utterly swamped. As they lose weight their beta cells can cope once again - actually there is a danger of hypoglycemia because they are still tuned for the badly overloaded state. This condition is distinct from insulin resistance, and in turn distinct from beta cell apoptosis. They all share one thing in common which is an effective insulin deficiency.

[Caravaggio]

Does the woman who was "cured" of Type 2 diabetes able to eat as much carbs as she wants like a non-diabetic person and enjoy the same blood sugar response like a non-diabetic person, without meds, exercise or insulin?

[volleyball]

A recent article in one of the news magazines -Newsweek, IIRC - mentioned that a morbidly obese woman had lost a lot of weight and improved her health sub stantially. The article went on to say that her diabetes had been "cured."

Comments on this forum have suggested that diabetes is not curable, and that it can only be regulated. So, in consideration of the Newsweek article, could someone provide a pointer to a citation or an article that describes how diabetes in incurable, specifically Type 2 diabetes where there is some degree of insulin still being produced.

Thanks!

shel

So newsweek is where you are putting your medical faith? Good luck with that. I will be blunt because i suspect you are hoping for a cure. We did not suggest that you won't be cured. We said you won't be. and if you listen without rose colored glasses you will find out they define cure in a funny way. every one of them

[Subby]

It does bring into question some of the long held theories or research as to the causes, and conditions of diabetes to me. Like how can something where told for the most part that the pancreas has stopped functioning or if it hasn't one day will. How can all of a sudden that not be so? ( I may have the technical parts wrong but I am sure you will get the gist)

When the pancreas stops working, as is the case very quickly for type 1 and usually over a lot longer time for t2, there is obviously no chance "curing" or "remission" through removing visceral insulin (weight loss). Where the pancreas still works by and large, as may be the case for many early stage T2s, and has the excessive demand for insulin dramatically taken off - well, you can see how that can lead to recovery of some sort. Still lots of question marks in the long term.

[jillybean]

I'm with others - depends on your definition of "cured." If I can pass a glucose tolerance test, am I cured? But then if I go back to eating crappy all the time, regain all the weight I've lost, and become diabetic again, was I ever really cured, or was I just well controlled?

And yet again, isn't almost everyone who's never even had diabetes technically just well controlled because if they all gained a bunch of weight and made poor lifestyle choices for an extended period of time, diabetes would appear?

There is no clearcut answer. I'm hoping for "remission" and good control, but I have stopped using the word "cure" because I think that gives the impression that I would no longer have to be careful about my choices. While I might be able to be less careful, I can never go back to 300+ pounds with daily trips to McD's or 7-11 for junk or the big D will just rear its ugly head again.

[pdxdennisj]

Early on, before death of too many beta cells, a person can force diabetes into remission (type 2) by loosing weight. The diabetes will re-emerge with gain of weight back- thus no "cure". After a few years of being type 2 and the beta cells being forced into hyperactivity to produce insulin, many beta cells die. This is what forces people from oral meds to insulin (which many now think they should have been on in the first place) At this piont there is no remission because there are not enough beta cells left to produce enough insulin. I think we don't know enough about what happens when people go into remission as a result of gastric bypass surgery.

[fgummett]

Early on, before death of too many beta cells, a person can force diabetes into remission (type 2) by [losing] weight. The diabetes will re-emerge with gain of weight back- thus no "cure". After a few years of being type 2 and the beta cells being forced into hyperactivity to produce insulin, many beta cells die.My understanding is that the beta-cells are overworked by Insulin Resistance for many years prior to the initial diagnosis of Type 2... these high levels of insulin may further contribute to the obesity (along with other symptoms of worsening BG control such as atherosclerosis) which in turn is associated with worsening IR and so on, in a vicious cycle.

[foxl]

What editor fell asleep over THAT one? Sheesh. Bet they get a lot of letters!

[Shel_B]

So newsweek is where you are putting your medical faith? Good luck with that. I will be blunt because i suspect you are hoping for a cure. We did not suggest that you won't be cured. We said you won't be. and if you listen without rose colored glasses you will find out they define cure in a funny way. every one of them

I am not putting my faith in anything,just merely asking a question. And, I am not hoping for a cure, again, just asking a question. So, please buzz off with your condescending comments.

shel

[Josselyn]

Hi Shel.
I think what you're going to find is that some Type 2s, through luck, effort, and much determination, can bring their numbers into a "normal" range. They might even pass an OGTT. In other words, they could present themselves to a new doctor, and for all intents and purposes, they would not be considered diabetic. That's my goal - if no cure is possible, then I want to reverse the symptoms. I want the dx reversed, if possible. If I have enough beta cell function left, and I continue to drop weight and stay exercised, I think it can be done. I want to buy life insurance, for instance, and I want no pre-existing condition costing me bigger bucks for that.

BUT, having said that, I do not for one minute think that I will ever again be able to eat indiscriminately for any length of time, gain weight, and not have diabetes rear its ugly head.

Ergo, I will not have been "cured"...I will have achieved very tight control and have reversed certain trends.

I've learned a lot since my dx in May, and it saddens me to say that as far as a cure goes, I no longer think it's possible to put that particular genie back into its bottle once it's been released...