Managing type 2 diabetes with Giloy: Know how the immunity-boosting herb can control blood sugar

From timesnownews.com/health

By Anushree Gupta

Giloy has recently been in the news for COVID-19 immunity, and pose-COVID care. However, very few people are aware that the herb can also help in the management of COVID-19

                                                                Photo Credit: iStock Images 

Key Highlights

• Type 2 diabetes affects millions of people around the world

• There exist herbs, remedies, and food items that can help in better management of the condition

• One such herb is Giloy - Know how it helps in blood sugar management and how you can use it.

New Delhi: Type 2 diabetes has reached epidemic levels all around the world, with the lifestyle disease affecting even younger people now. Type 2 diabetes cannot be reversed, however, effective treatment and management of blood sugar can ensure that the complications that arise from the disease are taken care of, and the rest of the body is not affected due to the disease. Apart from following a diet low in sugar content, diabetics should include certain foods in their diet as they help in reducing insulin resistance, boost production of insulin, and help to control blood sugar. One such food or herb is Giloy.

Giloy has recently been in the news for COVID-19 immunity, and pose-COVID care. Giloy is known for its immunity-boosting properties, and people, therefore, are consuming the herb in one form or another, to keep the risk of severe disease due to coronavirus at bay. However, very few people are aware that the herb is also a great remedy for diabetes, and can help in its management.

How Giloy helps in the management of Type 2 diabetes

According to a study undertaken by the National Centre for Biotechnology Information (NCBI), giloy has significant anti-diabetic activity and has an efficacy of 40 per cent to 80 per cent compared to insulin. 

Giloy is also known to have properties that help in burning extra glucose in the body, which helps to moderate sugar levels. The herb is a hypoglycaemic agent, which helps lower the levels of glucose in the system. 

Another way that giloy can help in diabetes management is that it aids in the natural production of insulin. Insulin is the enzyme responsible for the breakdown of sugar into the blood, and an imbalance in the same leads to high blood sugar levels, known as diabetes. 

Moreover, giloy also aids the digestive system and gut health. Both of these affect how well the food consumed in our body is absorbed by it, and therefore, affect type 2 diabetes. 

How can you use giloy to manage type 2 diabetes?

The best thing about giloy as a home remedy or treatment for type 2 diabetes is the ease of access and convenience of the herb. The herb is easily available in various forms, and you may consume it in whatever way possible. 

• Giloy leaves can be made into juice and consumed.
• You can consume giloy powder, available at all ayurvedic stores, with warm water.
• If you are on the go, you can consume giloy capsules.

If you consume giloy to manage diabetes, remember to consult your doctor and take your medicines accordingly, since it can lead to your blood sugar levels dropping too low, which can also be dangerous.

https://www.timesnownews.com/health/article/managing-type-2-diabetes-with-giloy-know-how-the-immunity-boosting-herb-can-control-blood-sugar/665440

Easier-to-use technology helps young people with type 1 diabetes

From scopeblog.stanford.edu

Technology that sends blood sugar-level updates to their smartphones improves outcomes for young people with type 1 diabetes, a Stanford trial shows.

Technology for treating type 1 diabetes is becoming easier to use, an especially beneficial change for teens and young adults, according to a recent study published in JAMA.

The clinical trial, conducted at Stanford Medicine and 13 other U.S. institutions, analysed whether the newest continuous blood glucose monitors are helpful for patients aged 14 to 24. The monitors rely on a wearable sensor that measures blood-sugar levels once every five minutes and sends the readings to a receiver or smartphone.

The study found that teens and young adults using these monitors had better long-term blood sugar control than those who used manual blood-sugar monitoring. That's big news because teens and young adults tend to have the most difficulty with blood-sugar control, said study co-author Priya Prahalad, MD, a paediatric endocrinologist at Stanford Children's Health.

"A big struggle exists for this age group: They want to be just like their friends, to live a normal life and snack and eat like their friends do, and they're self-conscious about being different from their peers," Prahalad said.

Discreet, quick checks via phone

With the new technology, instead of pulling out a glucometer, teens can check their blood sugars discreetly with a quick peek at their phones.  

Type 1 diabetes interferes with the body's ability to make insulin, a hormone that helps glucose -- the main sugar in blood -- move into muscle and other tissues for use as an energy source.

People with type 1 diabetes must check their blood sugar levels several times per day, including before eating, then calculate how much insulin to inject. Handheld glucometers require frequent, painful finger pricks to get a drop of blood for testing. Also, because middle-of-the-night checks are needed to catch dangerously low sugar levels, it's difficult for patients and their parents to get a good night's sleep.

The newest continuous glucose monitoring systems rely on a wearable sensor with a thin platinum wire inserted just under the patient's skin, so patients don't have to prick their fingers.

Dozens of blood-sugar measurements a day

The wire stays in place for 10 days, including while patients are bathing or swimming; changing it out is about as painful as an insulin injection, Prahalad said. The system records blood glucose once every five minutes, or 288 times per day. Patients can easily share the data by having it sent to a parent's phone as well as their own.

In the new study, 153 participants were randomly assigned to use either continuous monitoring systems or a handheld glucometer for six months. Most patients were consistent about using the automated technology until the end of the trial. For those who were, glycated hemoglobin levels, an indicator of long-term blood glucose control, were lower.

There are even bigger improvements ahead, Prahalad said.

"We're in a phase of diabetes research where we are developing more automated insulin-delivery systems, with insulin pumps that use continuous glucose monitoring as a key component," she said.

Using continuous monitoring sets teens and young adults up to take advantage of the next wave of "smart" diabetes devices, she said, adding "This is the future of diabetes care."

Photo by Yura Fresh

https://scopeblog.stanford.edu/2020/10/08/easier-to-use-technology-helps-young-people-with-type-1-diabetes/

How diabetes can affect your eyes

From telanganatoday.com

Diabetes is a condition wherein blood glucose levels are abnormally high

New Delhi: Glucose is an essential energy source for all living cells of the human body, which is programmed in a way wherein the glucose levels in the blood are maintained at an optimal level through various hormones.

Blood glucose levels are normally referred to as blood sugar levels in our day to day life. Diabetes is a condition wherein blood glucose levels are abnormally high. Consistently high glucose levels cause damage to various organs of the human body in the long run.

‘Diabetic Retinopathy’ is one such condition wherein abnormally high blood glucose or blood sugar levels cause slow, progressive and long-standing damage to the eyes.

Diabetes has now assumed the title of a silent global pandemic. With India set to become the diabetic capital of the world, the threat of visual loss due to diabetic retinopathy has gained massive proportions.

To understand how diabetes impacts the eyes, let us ? first understand the structure of the human eye. The human eye has structures and functions roughly equivalent to those of a simple camera. Similar to the light sensitive of a camera, the human eye has a light-sensitive structure called the retina.

It is this retina or the light sensitive structure of the human eye that is most adversely affected by diabetes. This condition is called diabetic retinopathy or is also referred to as diabetic eye disease in common understanding.

The advent of diabetic retinopathy simply starts as the appearance of small bleeding spots or “microaneurysms” on the surface of the retina. This is the initial stage of the disease or non-proliferative diabetic retinopathy, wherein the vision remains reasonably good despite having an abnormality.

The retinal blood vessels eventually develop leaks that cause the retinal tissue to “swell up like a sponge” (also called macular edema) It is this stage wherein an individual’s vision starts getting affected and prompts her to seek medical attention.

Treatments like the application of laser spots to the retina or instilling injections into the eye at this stage are very effective if instituted in time.

If the blood sugar levels continue to remain uncontrolled, the retina suffers from larger bleeding spots and blood may entirely fill up the jelly inside the eye causing a sudden loss of vision. Many patients go undetected until this stage of the disease because they miss undergoing an eye check-up while they suffer from diabetes all these years.

In the later stages of the retina starts getting crumpled and this results in a near-permanent loss of vision and blindness. Major surgery is then required to remove the blood and fix the retina back to its original position. Despite multiple major surgeries, only a few individuals may gain back their original vision.

As the diabetic eye disease progresses through the late stages, the microscopic damage to the cells of the retina leads to permanent structural and functional changes that, unfortunately, cannot be reversed.

Early detection of diabetic retinopathy and early treatment is hence, the key to preventing permanent visual loss due to diabetic eye disease.

It is strongly recommended to get a retina evaluation for every diabetic individual, at least once in a year. This retina evaluation is performed by an eye doctor who is a retina specialist and usually takes about an hour at the doctor’s clinic.

Long-standing diabetes, poor blood sugar control, associated hypertension, and deranged lipid pro? These are the most important risk factors for the development and progression of diabetic eye disease. Hence, all diabetics must have regular evaluations with the physician.

https://telanganatoday.com/how-diabetes-can-affect-your-eyes

Diabetes And Covid-19: Expert Tips And Full-Day Diet Plan For Diabetics

From food.ndtv.com

Research has shown that Diabetics are at a higher risk of COVID infection. Here are foods to include and a meal plan diabetics can follow

The pandemic gripping the entire world today has affected our health in varying ways. On one side, being locked in, we are eating home cooked food made with fresh ingredients and with our families. Traditional recipes are making a comeback into our lives. This is good and healthy. On the other side, we have seen that lack of physical activity, the stress of the scare of getting infected and prolonged stay at home is creating mental and physical ill-health. With respect to diabetes, from day one, Doctors have been telling us about the increased risk of infection in people with underlying co-morbidities like Diabetes, Heart disease, stroke and people of older ages.

Research has shown that diabetics are at a higher risk of COVID infection, and at a higher risk of the severity of the infection and complications that come with SARS- Severe Acute Respiratory Syndrome. Emerging evidence also points towards the fact that this infection makes diabetes control difficult because of the treatments involved. Conversely, uncontrolled blood sugars make controlling the infection that much more challenging. Also, it has been seen that a lot of obese and pre-diabetics have become diabetics with the onset of COVID infection. To protect against the infection, Diabetics are not stepping out, thus leading to a lack of physical activity. Add to this poor food choices, stress, uncontrolled blood sugars, and increased BMI. It seems like a vicious circle, but you can break this by making the right choices for a healthier lifestyle.

Here Are 5 Tips For Diabetics To Eat Right During Covid-19:

1. Eat At The Right Time: This time isn't a weekend; you are at home to stay safe and it's a long time. Eating at proper times means a better regulation of blood sugars by preventing binge eating, supplying a steady and measured carbohydrate in the blood preventing spikes and troughs. Eat within 1 hour of waking up and eat every 3-4 hours. Three well-planned major meals, with two snacks in between is a good strategy to follow. Close the kitchen by 9pm, take a cup of milk at bedtime.

2. Add Whole Grains: Make sure you add whole grains in at least 3/4th meals. They ensure a slow and steady supply of carbs, keeping up your energy levels. Whole grain fibre slows down the release of glucose into the blood and at the same time provides many beneficial vitamins and minerals. Millets like Jau aka Barle, help control blood sugars. Try using them in one meal in two days at least.

_{Whole grain fibre slows down the release of glucose into the blood.}

3. Benefits Of Eating Protein: Proteins don't just build up a healthy body, they also add to the satiety value. Adequate protein intake for an adult is about 0.8g/kg body weight as per the recent guidelines of National Institute of Nutrition. High protein diets with very low carbs may be followed, but only if your doctors decides as they need very close follow-ups and monitoring. They have shown to control very high sugars but must not be tried without your doctor/dietician by your side. Plant proteins like legumes- Rajma, chana, lobia are excellent for sugar control. Low-saturated fat animal proteins from fishes, chicken breast, eggs can also be included safely. Fat free/ low fat milk and dahi also add quality proteins. Dahi or yogurt is a probiotic that enhances gut health which is directly related to better sugar controls.

4. Fats Oils And Nuts & Seeds: Healthy fats from plant sources like, Olive oil, Peanut oil, Rice bran oil in combination with Mustard or sesame oil have a beneficial effect on our health. Recent research has highlighted that replacing excess carbohydrates and saturated fats with healthy fat choices improves both blood sugars and insulin control. Eating an ounce of nuts & seeds, at least thrice a week, has shown better sugar controls and heart health.

5. Fruits And Vegetables: Fill up half your plate with vegetables and salads. Choose seasonal and colourful. Add the whites, greens, reds, orange and ensure that your body gets not just fibre but also lots of vitamins, minerals, antioxidants and phytonutrients that protect against infections, oxidative stress and boost the immune system. Two fruits a day make a good snack providing little carbs, with fibre and electrolytes keeping you full and your sugars stable.

Diabetes Meal Plan | Full Meal Plan For Diabetics At Home

So what should a Diabetic meal plan look like? Choose at least 4 components from each of the food groups to make a major meal:

Breakfast:

1. 2 small multigrain bread slice + 1 egg boiled/poached/ scrambled/ omelette+ 1 cup milk

2. 2 stuffed multigrain or whole wheat roti + big bowl of Dahi + mint chutney

3. 2-3 Idly/ dosai + Thick sambar 1 bowl + Dahi or thick lassi

Lunch/ Dinner

1. 2 chapati + 1 big bowl Rajmah + 1 big bowl palak+ Dahi

2. Parboiled rice (cooled down) + thick sambar or chicken breast in gravy + Cauliflower+ 1 Bowl dahi

3. Multi grain burger Bun + grilled Paneer / Chicken patty + lots of cucumber, lettuce leaves, tomato slices + 1 glass cold coffee. Make a burger at home, use mustard instead of Mayo

4. Veg Pulao + sprouts salad 1 bowl + Dahi or Chicken Biryani + Mixed Veg Raita which contains one bowl of vegetables.

Snack time:

1. Roasted foxnuts or makhana + 1 table spoon roasted peanuts

2. Boiled corn with Paneer cubes

3. Grilled/raw vegetables with 1 tablespoon peanut/almond butter

4. 1 fistful of almonds + walnut + chia seeds

These are just guidelines to explain balanced meals, get your personal diet plan from a registered nutritionist.

In addition to this, exercise. Even if you aren't going out, please take out 30-45 minutes and choose a workout that helps get your heart rate up. 10,000 steps are ideal and 15,000 steps prevent NCD's (Non-communicable diseases). Start today, add 250-500 steps every alternate day.

Stay safe, stay healthy, stay at home.

Disclaimer

The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

https://food.ndtv.com/health/diabetes-and-covid-19-expert-tips-and-full-day-diet-plan-for-diabetics-2305342

Type 2 diabetes - the popular herbal remedy shown to improve insulin and lower blood sugar

From express.co.uk

TYPE 2 diabetes is largely negligible if you keep your blood sugar levels under control. Consuming a particular fruit has been shown to stabilise blood levels

Type 2 diabetes is a chronic condition whereby a person's blood sugar levels keep rising. Blood sugar, or glucose, is the main sugar found in blood. The body obtains blood sugar from eating food and it is needed for energy and nutrients. High blood sugar levels can damage blood vessels that supply vital organs, however.

Ordinarily, the pancreas - an organ located in the abdomen - is tasked with secreting insulin to regulate blood sugar levels.

If you have type 2 diabetes, the pancreas does not provide enough insulin to regulate blood sugar or the insulin it does produce is not sufficiently absorbed by the cells.

As a result, diabetics are disproportionately at risk of high blood sugar levels.

There are ways you can compensate for insufficient insulin production, however.

You can lower your blood sugar levels by making healthy dietary decisions.

Evidence shows that specific dietary items boast blood sugar-lowering properties.

Bilberries - small, blue berries native to Northern Europe - have attracted the attention of researchers for this reason.

In fact, bilberries are a popular herbal remedy used to lower blood sugar levels in people with type 2 diabetes, research shows.

One study reported that a bilberry extract reduced blood sugar levels in adults with type 2 diabetes more effectively than a placebo.

The extract provided the equivalent of 50 grams of fresh bilberries.

Another eight-week study showed that a diet enriched with fresh bilberries increased insulin secretion in adults with metabolic syndrome; a cluster of conditions that increases your risk of type 2 diabetes, stroke, and heart disease.

Experts believe that the berries prevent the breakdown and absorption of carbohydrates in your gut, similarly to some blood-sugar-lowering medications.

Bilberries: Experts believe that the berries prevent the breakdown and absorption of carbohydrates

Carbs can cause blood sugar spikes because they are broken down into glucose relatively fast.

Animal studies suggest that the anthocyanins in bilberries may also stimulate the secretion of insulin.

General tips to lower blood sugar

In addition to reducing your carb intake and adding bilberries to your diet, you should engage in physical exercise.

"You should aim for 2.5 hours of activity a week," advises the NHS.

You can be active anywhere as long as what you're doing gets you out of breath.

Type 2 diabetes - how to spot it

Many people have type 2 diabetes without realising - this is because symptoms do not necessarily make you feel unwell.

Symptoms of type 2 diabetes can include:

• Peeing more than usual, particularly at night
• Feeling thirsty all the time
• Feeling very tired
• Losing weight without trying to
• Itching around your penis or vagina, or repeatedly getting thrush
• Cuts or wounds taking longer to heal
• Blurred vision.

The NHS recommends seeing a GP if:

• You have any of the symptoms of type 2 diabetes
• You're worried you may have a higher risk of getting type 2 diabetes.

https://www.express.co.uk/life-style/health/1343632/type-2-diabetes-symptoms-bilberries-diet-treatment-lower-blood-sugar

Good News for Those with Type 2 Diabetes: Healthy Lifestyle Matters

From chicagohealthonline.com

Type 2 diabetes is a metabolic disorder of insulin resistance — a reduced sensitivity to the action of insulin — which leads to high blood sugar, or hyperglycaemia. Approximately 12% of American adults have type 2 diabetes, and more than one-third of Americans have prediabetes, a precursor to type 2 diabetes. This is a major public health concern, as type 2 diabetes dramatically increases risk for heart disease, including heart attacks, atrial fibrillation, and heart failure.

The development and progression of type 2 diabetes is affected by many factors. Some, such as a person’s race/ethnicity, age, and gender cannot be modified. Others, including body weight, exercise, and diet can be changed.

Can lifestyle changes help reduce heart disease risk if you have diabetes?

In 2010, the American Heart Association (AHA) published “Life’s Simple 7,” which it defined as “seven risk factors that people can improve through lifestyle changes to help achieve ideal cardiovascular health.” The Simple 7 touched on smoking status, physical activity, ideal body weight, intake of fresh fruits and vegetables, blood sugar, cholesterol levels, and blood pressure.

Subsequent studies found that people in optimal ranges for each of these factors had lower risks of heart disease compared to people in poor ranges. But given the significant increase in heart disease risk in those with type 2 diabetes, it was not clear if the impact of these modifiable factors would hold true for the type 2 diabetes population.

Recent study suggests lifestyle changes do benefit type 2 diabetes and prediabetes

A study published in JAMA Cardiology looked at whether the ideal cardiovascular metrics covered in Life’s Simple 7 translate into improved cardiovascular health for those with type 2 diabetes or prediabetes. The results were exciting and consistent with other large population-based studies. Patients who had five or more ideal cardiovascular measures had no excess of cardiovascular events compared with people with normal blood sugar levels. Cardiovascular events measured in the study included death, heart attack, stroke, and heart failure. Each additional ideal health metric was associated with an additional 18% drop in cardiovascular event risk for people with type 2 diabetes and an additional 15% drop for those with prediabetes.

This was a prospective, observational study, examining the association of risk factors only. It was not a randomized trial looking at an intervention. As a result, we cannot draw conclusions about cause and effect. Nonetheless, this is the first study to show a positive association between ideal lifestyle factors and cardiovascular health in people who are at high risk for cardiovascular disease due to type 2 diabetes. These results showcase the importance of our lifestyle choices, suggesting that meeting ideal health metrics can help reduce risk of cardiovascular events.

Life’s Simple 7

So what are the lifestyle and metabolic health goals should you strive for, whether or not you have diabetes?

1. Manage blood pressure. 120/80 mm Hg or lower is best.
2. Control cholesterol. Aim for total cholesterol below 200 mg/dL.
3. Reduce blood sugar. Get your HbA1c (an average measure of blood sugar over the past three months) under 5.7% if you have prediabetes, or below 6.5% if you have type 2 diabetes.
4. Get active. Your goal is 150 minutes per week of moderate-intensity activity or 75 minutes per week of vigorous activity.
5. Eat better. That means at least 4.5 cups of fruits and vegetables per day.
6. Lose weight. You want a body mass index (BMI) of less than 25.
7. Stop smoking. You’ll reap cardiovascular benefits, not to mention lowering your risk for cancer, COPD, and much more.

(Alyson Kelley-Hedgepeth, MD, is a contributor to Harvard Health Publications.)

https://chicagohealthonline.com/good-news-for-those-with-type-2-diabetes-healthy-lifestyle-matters/

Achieving Type 2 Diabetes Remission through Weight Loss

From niddk.nih.gov

Studies have shown that significant weight loss, through either metabolic (also known as bariatric) surgery or calorie restriction, may lead to remission in some people who have type 2 diabetes

William T. Cefalu, MD, director of the NIDDK’s Division of Diabetes, Endocrinology, and Metabolic Diseases, discusses type 2 diabetes remission, including recent research into strategies and mechanisms by which people who have diabetes can achieve remission.

Q: What is remission of type 2 diabetes? How do health care professionals define remission and know when a patient has achieved it?

A: People with type 2 diabetes who do not have adequate glycaemic control have an increased risk for diabetes complications. Glycaemic control is monitored by measuring both blood glucose and blood markers assessing antecedent glycaemia such as haemoglobin A1C, which reflects average glucose over the previous months. We define type 2 diabetes remission as having the condition revert to a nondiabetic range as assessed with blood glucose levels or blood glucose markers and staying in that range for at least 6 months when a person isn’t taking any diabetes medications.

It’s important for both health care professionals and people who have type 2 diabetes to realize that significant weight loss either from lifestyle intervention (i.e., diet and exercise) or from certain procedures can result in blood glucose levels decreasing into the nondiabetic range, and that achieving remission can minimize or prevent future complications.

Q: Why do health care professionals use the term “remission” rather than “cure” when discussing type 2 diabetes? What happens to a person’s diabetes when he or she relapses?

A: We don't use the word “cure” when we refer to blood glucose levels reverting back to levels below the threshold used for diagnosis, as you could argue “cure” means completely alleviating the condition. For example, an acute condition seen with infectious diseases such as bronchitis may be considered to be cured with antibiotics. However, in type 2 diabetes, because blood glucose levels are on a continuum and are significantly associated with weight, it is observed that when weight regain occurs, the glucose levels may increase back to the range associated with diabetes diagnosis. So, the correct term is “remission.”

Type 2 diabetes is a progressive disorder, and, at one time, we didn’t think that weight loss or other interventions could allow people with type 2 diabetes to lower their blood glucose levels into the nondiabetic range and to stay there for an extended period of time without medication. However, we now understand that people with type 2 diabetes who lose significant weight and improve other factors related to diabetes can achieve remission.

With sustained weight loss, people may stay in remission for quite some time. However, if they begin to put on weight, their blood glucose levels can increase and return to the diabetic range. They may need diabetes medications or even insulin with weight regain depending on the severity of their type 2 diabetes and their glucose control.

Q: What strategies can lead to remission of type 2 diabetes?

A: The most important factor in achieving remission is weight loss, and two techniques—metabolic surgery and lifestyle changes that restrict calories on a daily basis to achieve weight loss—have been shown to induce remission.

Some studies, dating back many years, have observed that metabolic surgery leads to high rates of type 2 diabetes remission. Recently, the Diabetes Remission Clinical Trial (DiRECT) NIH external link, conducted in primary care practices in the United Kingdom, examined type 2 diabetes remission rates in participants who lost weight, starting with a very low-calorie diet and sustaining the weight loss over time. DiRECT found high rates of type 2 diabetes remission among people who lost a significant amount of weight—more than 10 kg (about 22 pounds)—and sustained the weight loss over 12 to 24 months.

Q: What research is being conducted on remission of type 2 diabetes?

A: Studies have sought to understand the mechanisms of remission. A lot of current research focuses on not only total fat in the body, but also where the fat may be located, referred to as “ectopic fat” (e.g., fat in the liver and pancreas) that may affect normal physiologic function. This research has led to some very interesting observations about potential mechanisms. Weight loss may improve pancreas function, with better insulin secretion and type 2 diabetes remission.

Q: Are some people with type 2 diabetes more likely to achieve remission than others?

A: Three factors that seem to predict success in achieving remission are significant weight loss, baseline pancreatic function, and diabetes duration.

Significant and sustained weight loss—for example, in the range of 10 kg (about 22 pounds) as shown in some studies—is the most important factor. Studies in which participants lost small amounts of weight have shown lower rates of type 2 diabetes remission. However, studies in which participants lost a significant amount of weight—such as DiRECT or studies of metabolic surgery—have shown higher remission rates.

Studies of weight loss through restricting calories or metabolic surgery have found that people with type 2 diabetes who start with greater pancreatic function at baseline, prior to the intervention, are more likely to undergo remission. People who have had shorter diabetes duration are also more likely to undergo remission. Type 2 diabetes is a progressive disease, and, after a long time with diabetes, pancreatic function may decline over time. Thus, observations suggest that after having diabetes for a long period of time, significantly improving pancreatic function and achieving remission may prove to be more difficult, compared to achieving remission early in the natural history of the disease.

Q: How and when should health care professionals talk with patients who have type 2 diabetes about remission? How can health care professionals help patients achieve remission and sustain it over time?

A: First and foremost, you should emphasize the importance of managing blood glucose levels to minimize the complications of type 2 diabetes whether the patient is or is not on medications. Glycaemic control is incredibly important in reducing the risk of complications, and you need to discuss glycaemic control and a goal with the patient. In most cases, this means advising patients to keep their A1C level at 7 percent or below to prevent eye, kidney, and nerve complications. While we have very effective medications to lower blood glucose levels, lifestyle interventions (nutrition and exercise) are a cornerstone of managing diabetes. A balanced diet that achieves weight loss not only improves blood glucose levels but also may reduce cardiovascular risk factors.

Patients should also know that obesity contributes to increased blood glucose levels due to insulin resistance and that the more weight patients put on, that may mean they need more medication. It is important that they know if they lose weight and improve their body’s efficiency, they may require less medication. Let your patients know that if they lose enough weight, particularly during the early phases of type 2 diabetes, they will significantly lower their blood glucose, have less risk for diabetes complications, and may be able to achieve remission.

Overall, with significant weight loss through restricting calories or other strategies, patients have a high likelihood of achieving remission, particularly if they have a greater baseline pancreatic function and have had diabetes for a shorter time.

https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/achieving-type-2-diabetes-remission-through-weight-loss