Is diabetes really reversible?: Experts Talk at Smart Hospital, Ghaziabad

New Delhi [India], December 13 (ANI/PNN): "The term 'reversal' is far from reality yet, however, "remission" can be used alternatively...", said Dr Omkar Singh, Head of the Department of Internal Medicine & Critical Care at the Smart Hospital, Ghaziabad.
India is often referred to as 'the diabetes capital of the world, as it accounts for about 17% of the total number of diabetes patients in the world. The International Diabetic Federation recently estimated close to 80 million diabetic patients in 2021 in India.
Summing up the diabetes awareness month (November), experts at the Smart Hospital, Ghaziabad, held a panel discussion to bust myths about the diabetes reversal programs. The session was primarily led by Dr Omkar Singh (Head of the Department of Medicine) and Dr Naved Akhter (Head of the Department of Pediatrics & Neonatology), moderated by other experts.
"Reverse Diabetes in 6 weeks" or "Reverse Diabetes naturally", have become the cult phrases that one may encounter often across the social media platforms. But can the condition be "reversed"? The word 'reversal' is misleading. " The term 'reversal' is far from reality yet, however, "remission" can be used alternatively; as of now 'remission' is defined as HB1C<6.5 after 3 months of stopping medicine," said Dr Omkar Singh, Head of the Department Medicine at the Smart Hospital, Ghaziabad.
Why is the term misleading? "That is because 'reversal' implies that the medicines have stopped and the patient no longer suffers from the disease. This scenario is seldom seen in patients with prediabetes who maintain a lifestyle with astute discipline to keep their blood sugar levels balanced. However, patients with chronic, long-standing diabetes find it difficult to control sugar levels even with reduced medications.", Dr Naved added.
Another expert from the panel further clarified that the term "reversal" might in reality imply "a better management of the disease" and not necessarily getting rid of it permanently. However, if the patient sustains without medications and blood sugar levels within the normal limits for five years and more, we may say that the Type 2 Diabetes has been reversed.
Myth 1: Type 2 Diabetes reversal is easy and can be achieved within 6-8 weeks of joining a program
This is one of the common claims made by budding health tech companies; however, the experts find it funny and dangerous. Dr Omkar comments, " It can sometimes be seen in recently diagnosed patients that they reach the desired goal, however research shows that over a period of time sugar levels again start to rise and cause chronic deficiencies later."
As per ADA (American Diabetes Association) guidelines, taking a very low calorie diet i.e 600k cal/day can reverse diabetes initially but even after a year of consistent efforts only 50% of the patients sustain reversed sugar levels. Some patients even rush back to their original doctors with double the medications after the damage is being done.
Myth 2: Fasting can reverse diabetes
"This has become more of a trend than a myth", says the expert. "Yes, it works, but only initially," he added. The patient may witness a drastic drop in weight and improvement in the gut. Fasting is an age-old practice and works like magic if done right.
However, it only depends on diabetes to diabetes and comorbidities associated with the patient. Fasting occasionally works fine, but if you're fasting in a routine for days and weeks, then you should be worried about your muscle health and metabolism. Thus, a diabetic patient must follow fasting practice with the right guidance.
Myth 3: cutting on carbs and sugar will reverse diabetes.
Diet low on carbs and sugar is currently in trend called Ketogenic diet. As per the panel, yes, it definitely works. The patients will get the sugar levels down but will also miss out on the nutritional benefits at the same time. The major cause of diabetes is insulin resistance or inflammation, induced via refined sugar or carbohydrates present in cakes, cookies, pastries, packed food and in fruits. However, strategically paired with grains, fibre, and fats can do wonders for you. Thus, a Keto diet should be followed under guidance and patients with ongoing nephropathy should avoid it.
Myth 4: Genetic Diabetes is the most chronic one
This is one of the most common myths that float around. Family history does play a huge role in your diabetes. However, the severity of the disease majorly depends on your lifestyle, eating habits and comorbidities. Thus, you should be more disciplined and consistent about your health than people who are not pre-exposed to the disease.
Myth 5: Type 1 diabetes can be reversed
If anybody claims this statement and you blindly believe it, then you live under a rock. It has been half a century of research on this condition and the results are still inconclusive. Even ADA (American Diabetes Association) doesn't affirm the statement. We all need patience and hope while maintaining our health and lifestyle.
In conclusion, the Smart Hospital's expert panel presented a fairly scientific view of the disease. Diabetes 'remission' is only possible through 3 ways having their own set of pros and cons. First, a low calorie diet (i.e 600 cal/day) that works for 50% of the patients but may induce lethargy, fatigue and minor immobility. Second, a low carbs 'Ketogenic diet' that has to be followed under expert guidance only. Finally, Bariatric Surgery that one may sustain for 12 years. However, there are a few things that one cannot go wrong with like building a healthy lifestyle, checking blood sugar levels regularly and getting an eye (fundus) examination done after every few months.
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