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Type 2 diabetes: Reversing the diagnosis

Diabetes, Weight loss | September 21, 2014 | Author: The Super Pharmacist

weight, diabetes

Type 2 diabetes: Reversing the diagnosis

Type 2 diabetes is a condition in which cells in the body become less sensitive to the effects of insulin. Insulin is required for sugar to pass from the bloodstream into cells. In the absence of insulin or if cells do not respond to the effects of insulin, sugar remains in the bloodstream and causes several short and long-term problems.

It turns out that the cause and the cure of type 2 diabetes are one and the same: obesity. While some people will develop type 2 diabetes without being obese, much more often than not, a person with type 2 diabetes will be overweight or obese. Fortunately, type 2 diabetes is extremely responsive to changes in weight, which means that type 2 diabetes is reversible.

Reversing Type 2 diabetes is possible

Like the diagnosis of high blood pressure (hypertension), the diagnosis of type 2 diabetes is made when one or more laboratory tests exceed a threshold level. Using high blood pressure as an example, if one’s blood pressure at rest is above 140/90 on more than one occasion, that person has high blood pressure. If they can reduce their blood pressure below this value, without medication, they would no longer qualify for the diagnosis of hypertension. The same holds true for type 2 diabetes. If someone with the diagnosis can reduce their numbers, which we will discuss, they can effectively reverse the diagnosis altogether.

The diagnosis of type 2 diabetes

type 2 diabetesThere are three ways in which someone can receive the diagnosis of type 2 diabetes:

  • Blood glucose measurements
  • An oral glucose tolerance test
  • Hemoglobin A1C levels

Blood glucose measurements

A blood glucose test is simply the amount of glucose that is circulating in your bloodstream at any given time. This can be done rapidly with a “finger stick” blood sample measured with a blood glucose monitor or it can be measured in a laboratory in blood taken in a vial by a phlebotomist. In order to be considered a fasting blood glucose measurement, the patient must have fasted (that means consuming no calories) for eight hours before the test.

Diabetes: Fasting blood glucose level greater than 7 mmol/L

Prediabetes: (impaired glucose tolerance): Fasting blood glucose level = 5.5 to 7 mmol/L

Oral glucose tolerance test

If your physician suspects you may have diabetes, she may prescribe an oral glucose tolerance test. In this test, you consume a sugary solution and your blood glucose is measured before and two hours after consuming the solution.

If your blood glucose levels are above 11.1 mmol/L at two hours, you have type 2 diabetes. Incidentally, a two-hour glucose reading between 7.8 and 11.1 mmol/L is considered impaired glucose tolerance (sometimes also called prediabetes).

Hemoglobin A1C levels

Hemoglobin A1C (HbA1C) or glycated hemoglobin, is a form of hemoglobin in red blood cells to which sugar molecules in the blood stick. The more glucose that is circulating in the bloodstream, the more that is available to stick to hemoglobin.

While a blood The diagnosis of type 2 diabetesglucose test provides a snapshot of the sugar level in the blood at that moment, hemoglobin A1C provides your physician and you with an estimate of what your blood sugar levels were over the previous three months.

Why three months? Because red blood cells live, on average, 2-3 months. When red blood cells die, the hemoglobin (and hemoglobin A1C) is removed from the body. 

The hemoglobin A1C test is not only a way to diagnose type 2 diabetes, it is also the main way the doctor can track how well diabetes is managed.

The American diabetes Association, the European Association for the Study of Diabetes, and the World Health Organization all agree that a hemoglobin A1C ≥ 6.5% indicates a diagnosis of diabetes. A person with a hemoglobin A1C between 5.7 and 6.4% is an increased risk for developing type 2 diabetes and can be said to have prediabetes.

How to reverse the diagnosis of type 2 diabetes

People who are first diagnosed with type 2 diabetes or prediabetes have a choice as to whether they want to take medication and or insulin injections for the rest of their lives or trying to reverse the diagnosis through diet, exercise, and weight loss. For those who wish to avoid medications, weight loss is an effective option. Many studies have shown that people with type 2 diabetes or prediabetes who can lose weight and maintain a healthy weight can greatly reduce the risk of diabetes or reverse the diagnosis altogether.

How to reverse the diagnosis of type 2 diabetesImprovements in diabetes are related to the number of calories eaten in a day and to the overall weight that can be lost.

People who can reduce the calories that they keep each day will see improvements in:

  • insulin requirements
  • blood sugar levels
  • blood pressure readings 
  • other risk factors

While type 2 diabetes is heavily dependent on a person's body weight, long-term benefits usually cannot be obtained by calorie restriction alone. In other words, people who are committed to reversing the diagnosis of type 2 diabetes must reduce the number of calories they consume and increase the amount of exercise they perform, regardless of their body weight.

People who exercise more can delay or prevent the progression from prediabetes to diabetes. Unfortunately, relatively few people are able to maintain a healthy diet and perform daily exercise.

In a clinical trial of people with prediabetes/diabetes, 80% of participants exercised regularly at six weeks into the trial. By three months, less than 50% of those who started the trial were still exercising regularly. By one year, less than 20% maintain that same level of exercise. Those participants who managed to keep exercising saw dramatic benefits in their diabetes.

Individuals who cannot maintain a healthy diet or regular exercise may have other options, such as weight loss surgery and medication that can help reduce body weight. Unfortunately, these are not without side effects and complications. Moreover, weight loss surgery or drugs do not seem to be as effective on reversing type 2 diabetes as diet and exercise. Australia's best online pharmacy


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International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. Jul 2009;32(7):1327-1334. doi:10.2337/dc09-9033

Henry RR, Scheaffer L, Olefsky JM. Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab. Nov 1985;61(5):917-925. doi:10.1210/jcem-61-5-917

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