HCPC Registered Dietitian Mei Wan covers all your frequently asked questions about type 2 diabetes
Can you put type 2 diabetes into remission?
Take home message...
Type 2 diabetes was previously thought to be irreversible, but research has shown that with professional support from diabetes specialist dietitians, it is now possible to put diabetes into remission. Focus on the things you can change as well as eating whole foods and weight loss (if applicable) and your blood glucose levels will likely improve.
What is type 2 diabetes?
Type 2 diabetes is when the pancreas doesn’t make enough of a hormone called insulin or insulin is not used properly by the body (this is also known as insulin resistance).
Common symptoms include:
- Changes in vision
- Feeling exhausted
- Frequent urination
- Extreme thirst
- Unintentional weight loss
- Itchy genitalia
It’s recommended to speak to your doctor if you have any of the above symptoms.
If the doctor feels it’s necessary, they will ask for a urine and blood test to check your blood sugar levels.
An HbA1c of 48mmol/L or above indicates type 2 diabetes (normal blood glucose is 41mmol/L and below).
Why should I care?
According to Diabetes UK, there are 4,410,000 people living with type 2 diabetes in the UK [1].
This condition impacts the quality of life in different ways and there are some serious complications that you should be aware of:
- Retinopathy (eye problems)
- Foot issues (that may lead to amputation)
- Increased risk of heart attack and stroke
- Neuropathy (damage to the nerves)
- Sexual problems
- Mouth and gum problems
- Nephropathy (kidney issues)
- Increased risk of developing some cancers
What increases my risk of developing type 2 diabetes?
There are factors that increase your chances of getting diabetes:
- Age – the risk increases with age
- Family history – the risk increases if your parent(s) and/or sibling(s) are living with type 2 diabetes
- Ethnicity – South Asian, African-Carribean and Black African heritages are two to four times more likely to develop type 2 diabetes
- Blood pressure - Your past history of raised blood pressure or you are currently living with high blood pressure
- Weight - If you carry more weight around the tummy area
- If you have had a history of gestational diabetes – this may affect pregnant women from approximately weeks 14-27 (second trimester) to weeks 28-40 (third trimester)
- Active use of antipsychotic medications – the risk is low however some medications carry the side effect of weight gain
- Polycystic ovary syndrome (PCOS) - the condition is associated with higher levels of circulation insulin therefore there is an increased risk of insulin resistance
What simple changes can I make?
There are many things that you can change to help improve your blood glucose:
- Stopping smoking
- No more than 14 units of alcohol a week and it should be evenly spread out over 3-4 days plus including alcohol-free days in between
- Being active and breaking up long periods of sitting down helps to improve your insulin response
- Protect your sleep and find ways to unwind and relax before your head rests on your pillow
- Better dietary choices - What you choose to eat matters (more discussed below)
Which dietary changes can help?
- Experiment with dietary approaches that work for you and your lifestyle as there is no single approach that will suit everyone – you are as unique as your smile. The following strategies have all been shown to work [2] with the aims of improving blood glucose control and weight loss (if applicable):
- Carbohydrate counting
- Low-carb diet
- High fibre and high protein
- Calorie counting
- Portion control of carbs, protein and fat
- Mediterranean diet
- Focus on whole foods and limit take aways or eating out in restaurants as the portions are normally larger than what you would serve yourself at home and likely to be high in (saturated) fat, salt and sugar
What does science say about remission?
In the DiRECT trial (2017), it showed participants classed as ‘overweight’ or ‘obese’ put type 2 diabetes into remission if they were able to achieve a 15kg weight reduction over a twelve-week period on a low calorie diet programme (using soups and shakes) [3].
With such fantastic results, this sparked an interest within the NHS in running several trials across the UK.The programmes are heavily focused on weight loss as a primary goal and there are strict eligibility criteria – the doctors use this screening tool for safety reasons.The structure of the programme may not suit everyone, especially for those with a history of disordered eating or currently struggling with body image (due to rapid weight loss may cause loose skin folds).
If you are interested in joining a programme please speak to your GP.
What if I’ve been diagnosed with pre-diabetes?
Pre-diabetes is when your HbA1c is between 42 to 47mmol/L – at this stage, there are many simple changes that you can make to stop the risk of developing type 2 diabetes.
You can still take on board the suggestions above to make changes to your dietary choices and levels of activity.
Most importantly, get support
Probably the most important thing you can do is to ask for support from a Registered Dietitian that specialises in type 2 diabetes prevention and management.
Please don’t think you have to do this on your own or can just 'Google your answer'!
There is overwhelming, non-science-backed information and anecdotal strategies that may cause more harm than good. Speak to your Doctor or find a Registered Dietitian to support your health goals.
