Most, but not all, people with type 2 diabetes have enough remaining insulin-producing function to achieve diabetes remission--normal blood sugar levels without medication. The goal of lifestyle change is to get as close to remission as possible--a process I call "diabetes reversal". To learn more, please see my two-part series "What is Diabetes Reversal".
Hi Mike, thanks for producing and sharing such a greatly needed work.
So far with 1 screen-full of reading my 1st impression is to leverage OBESITY REVERSAL as an analogy for TYPE 2 REVERSAL. The text seems to need that readily tangible concept of what reversal means. Like a once fat person CAN live and eat normally without temptation to return to 5K calories/day.
What's so nice about you writing this Mike is the ENCOURAGEMENT aspect it offers people for having hope in reversal. A thing that's been denied while its voice eliminated (eg: mine is often controversial due to it sounding "out there").
I hope you're work grows nicely into a book like Burnsteins and McCulley's. IMHO both of them are so extreme and seem to never get to the full revesal-maintenance. So instead they're left with cultish-feelings of biggest-looser or some sort of fitness-forever. Good initial science indications, successes, but not the full pictures like you and I seem to grasp for.
Also, my senses as a gradualist enjoy what I'm reading so far as it allows for the context of the indivudals... Diving back in!
"Over time, as the insulin-producing cells of the pancreas continue to wear out, the blood sugar levels rise further and we recognize this as type 2 diabetes. "
IMHO, the the "wear out" phrase doesn't perfectly fit there. Sure some cells may wear out, die, others may grow, and yet more may recover. But as long as a person is T2 its IMHO the cells are not worn out completely. Where I think your text is correct is that the constant assault on the pancreas damages and weakens the cells that are presently in the pancreas which effects future cells. Suggestion:
"Over time, as the insulin-producing cells of the pancreas continue to weaken, the blood sugar levels rise further and we recognize this as type 2 diabetes. "
"I do not use the word "cure" because the diabetes will re-emerge if the lifestyle changes are not sustained, and can even relapse despite ongoing adherence and weight loss. Whether patients can sustain remissions for decades remains to be seen. "
Hi Mike, To advocate a reversal, you need to suggest at least the hope of a real "cure". Again curing obeasity would be a good analogy. People can but there are perspectives about making such a use of the terms. Still its a victory that's needed so please go all the way on it. As a cured type 2 I'll do my best to back you up. I've also cured obeasity (though you can see I'm not 100% cured of that - more like 70% lol). Suggested update:
"I hesitate to use the word "cure" because the diabetes will re-emerge if the lifestyle changes are not sustained, and can even relapse despite ongoing adherence and weight loss. Whether patients can sustain remissions for decades remains to be seen.Yet, like obesity can be considered "cured" when the individual believes and demonstrates they have gained personal control and perspective, I hope the same for Type 2. "
I've considered buying an A1C test but just not $motivated while I have some test strips left form that huge bulk supply that I bought 4 years ago.
I can say that my fasting BG is usally about 100 to 105 and sometimes (hmmm post thanksgiving) it will drift up toward 110-115 (right now its 111 and I've not eaten today, this a.m. it was 115). I also am at a 200 lbs while I "should" be at 165.
So if I had an A1C today my best guess is it would be between 5.0 and 5.5. AND that it would be 5.0 or less if I kept my weight where I should. (yea a bit annoyed at myself for the wt).
reitze, you say that your fasting BG is 100-105, up to 115 when eating more. This fasting number is NOT the blood glucose average number that the A1c corresponds to. That average number would also include the much higher numbers that would occur even 1/2 after eating a large meal, even thought those numbers would generally come down after 2 hours.
"Average" means every number, every minute of the day, awake or asleep, full or fasting. Therefore is your fasting is 105, your average might be in the 120's or 130's or higher depending on how many carbohydrate foods you are eating.
Absolutely right, Flute. I had an excellent A1C at one time of 6.2. I say excellent at that point, because my first one was 13.2, average 393 daily. LOL. Lovely. In that 6.2 A1C average, I had a blood sugar of 435 (two hours after my meal) and then some lows in the 30's and 50's. What was happening when I didn't take my blood sugar, who knows. Yet, we arrived at an A1C of 6.2. That high was because my insulin was a day older than it should have been and it didn't work at all. One day without insulin and my BS rises to the sky to greet the angels. Good thing, I didn't.
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