Is Diabetes Reversal a Reality?

Q. What is diabetes reversible?
A. Diabetes cannot be reversed, but it may be readily managed if you maintain a rigorous diet and exercise plan and take frequent medication. However, if the lifestyle changes then medicine can be are stopped and blood glucose levels would also increase. Otherwise, it can be managed without a tablet as well as with one. So we don’t call it diabetes reversal but we call it diabetic management.

Q. what are the cases of Diabetes reversal?
A. Diabetes reversal is a regular occurrence in people after gastric bypass surgery. If the patient has diabetes, they are unable to eat much after surgery, and their physical activity drastically lower their weight, leading in diabetes reversal. As a result, all patients who have had bariatric surgery have a 10% probability of entering the phase of diabetes reversal, which means their blood sugar will be managed for the following year.

Q. Reversal is a common phenomenon?
A. Reversal is very rare as it occurs only when blood sugar remains maintained at an absolute level of less than 7% for more than a year. So, if someone’s blood sugar is managed for more than a year without therapy, we may retain it in the category of reversal; otherwise, it’s controlled.

Q.  How can we judge whether diabetes is reversing?
A. If someone’s blood glucose and sugar level is high and diabetes is reversed by some mechanism like weight reduction, or lifestyle changes then the glucose remains in the normal range, and there is no added risk of problems in terms of diabetes. However, it is depend on the length of diabetes prior to reversal. Complications may begin if the period is prolonged. However, if the period is brief and diabetes is reversed, you may not suffer from long-term diabetic consequences.

Q. What are the steps to be followed for diabetes reversal?
A. Reversal of diabetes is an extremely uncommon phenomenon. If you follow diet and lifestyle modification and if you follow regular exercise, diabetes can be easily controlled. In a few hundred patients, hardly 1% suffer from reversal; otherwise, most of the patients can be controlled.

Q. Can you suggest some routine treatments?
A. The best treatment of lifestyle diabetes is the modification. We need to avoid excess fat in our food, cut down on calories, and do good physical activities like morning walks and evening walks. If that is not enough, we add some tablets and insulin. This is routine management.
Now a days, new drugs are in trial, where insulin-like injections are available, which can be injected once a week, and tablets that can be taken once a week only, but these are still in the experimental stage, and we are not sure when they will be introduced in the market or if they will be successful in the market.

Dr. Rajesh Khadgawat, Professor, Endocronology Department, Aiims, Delhi