One way street diabetes?
All content is checked by medical journalists.MunichEating healthily, exercising more, reducing excess weight - theoretically, type 2 diabetes can be improved by a consistent lifestyle change. In some cases, patients even no longer need any medication at all. But that is apparently less common than expected.
This is the conclusion US researchers came to when they searched the medical records of more than 120,000 type 2 diabetics for remissions. The scientists rated remission when a patient had good long-term blood sugar levels for twelve months even without medication due to a change in lifestyle.
But that was seldom the case. Andrew Karter's team from Kaiser Permanente Northern California found that only 0.14 percent of participants achieved a complete remission with HAbA1c levels below 5.7 percent. A partial remission (HbA1C value 5.7 to 6.4 percent) managed at least 1.5 percent.
Those who act early have better chances
The investigation also showed, however, that the chances are much better if the lifestyle is turned inside out as early as possible. Of the patients who had suffered from diabetes for a maximum of two years, twelve percent managed to stabilize their blood sugar levels again. 4.5 percent of those who had not yet taken any medication were successful. An early diagnosis can therefore significantly improve the prognosis.
In addition, even if it is not possible to keep blood sugar levels in check with more exercise and a healthy diet alone, a change in lifestyle is worthwhile. In combination with medication, such measures can help stabilize blood sugar and prevent serious long-term consequential damage. This was also pointed out by private lecturer Wolfgang Rathmann at the Diabetes Update in Düsseldorf, about which the medical newspaper reported.
Remission after gastric surgery
Much more often than after a lifestyle change, remissions are observed in type 2 diabetes when the patients are given a so-called gastric bypass because they are very overweight. Why this is so has not yet been fully clarified. What is certain, however, is that this phenomenon cannot be explained by weight loss - remission begins before the patient has lost significant amounts of weight. However, the procedure is risky and cannot be reversed. It is therefore only carried out on very obese people.
Creeping course of the disease
Around six million adults who have been diagnosed with diabetes live in Germany. Over 90 percent of them are type 2 diabetics. In contrast to type 1 diabetes, in which the body's own defenses attack the insulin-producing cells, the sensitivity of the body cells to the sugar transporter insulin gradually decreases in type 2 diabetics. To compensate for this, the body has to produce more and more insulin. At some point, the insulin-producing cells in the pancreas are exhausted and the production is no longer sufficient to keep the blood sugar stable.
Type 2 diabetes is caused by a combination of genetic predisposition and, as a rule, an unfavorable lifestyle, especially if it leads to obesity.
Sources:
Andrew J. Karter: Incidence of Remission in Adults With Type 2 Diabetes: The Diabetes & Aging Study, Diabetes Care December 2014 vol. 37 no.12 3188-3195
Doctors newspaper, www.aerztezeitung.de; 01.04.2015
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