Is diabetes reversible: Diabetologist Dr. Milind Patil

Dr. Milind Patil

Is diabetes reversible? Can a patient with diabetes get rid of medicines?

These are the million dollar questions for every patient with diabetes. India is going to become the capital of Diabetes soon. So these questions are also important to the whole Nation. So it may not be wrong to say that “Nation wants to know whether diabetes is reversible or not ”. If someone does google research for this question he may become 100 per cent sure that diabetes is just like a fever, cold and can be reversed easily. He will get n number of the way to get rid of diabetes.

But when he/ she enter in doctor’s clinic with this knowledge what he/she gets is the sheer disappointment. They are simply told that once diabetes is the forever diabetes. Few patients find it very difficult to understand these opposing statements. With failing faith in doctors and attractiveness in diabetes reversal advertisements, these patients believe in these advertisements. To worsen scenario someone suggests to these patients that its doctor and pharma conspiracy to prescribe you medicines so that their roti and chulha will continue. Ultimately these patients stop English medicine and try natural ways to reverse diabetes. Later they land up in the hospital with the complications which could have been prevented. By the time they realize futileness of these efforts to reverse diabetes in the natural way the precious time has gone. Any fellow with a sound mind can understand that advertisement claiming to reverse diabetes in 3 days or 8 days is Jumala.

If some therapy can reverse diabetes why it has not been standard practice? Why are these ways not presented in any scientific forum? Why all these advertisements show few patients while standard medicines present data on a thousand patients? Why do these advertisements not show failure rate while standard medicine’s study tells us about side effects and efficiency rate?

The nation should also know answers to these questions. So this leads to another question – Can we reverse diabetes in a scientific way?
To understand the science let us see what is diabetes. It is the disease where glucose levels rise in the blood. There are multiple types of diabetes like type 1, type 2, genetic syndrome and drugs.

Type 1 Diabetes occurs when the body does not produce insulin. These patients require insulin lifelong. These patients can get rid of insulin if their body starts producing insulin again. There are no natural ways to increase insulin production. The other way to increase insulin production is getting other persons pancreas in the body by the process called pancreatic transplantation. The newly added pancreas create insulin hence these patient don’t require insulin. So practically these patients will be off insulin.

Then why don’t doctors advise pancreatic transplantation to every patient?
The pancreatic transplantation is the complex procedure. Similar to any major surgery it can be associated with the complications. Besides, it has its own set of problems. As the new pancreas is a foreign body, the patient’s immune system tries to act against it. To avoid this fight (rejection in medical terms) these patients require lifelong medicines to suppress a patient’s immunity. These medicines will have their own side effects. So practically patient is not off the medicine. The other medicines like BCG vaccine and multiple immunotherapies had not provided significant improvement. So at the present time type 1, Diabetes can’t be cured.

Does that mean a patient with type 1 Diabetes should feel discouraged?
No. The insulin therapy had changed the scenario of type 1 Diabetes. Before the discovery of insulin death within a few months of diagnosis was the final outcome in type 1diabetes. But now with the advances in insulin therapy patient with type 1 diabetes can have the normal healthy life.
So till researchers find out some novel therapy insulin is the only solution for type 1 diabetes.

There are some genetic disorders where diabetes develops. As we can’t reverse genetic abnormality we cannot reverse these type of diabetes. Certain medicines like steroids, psychiatry medicines can cause diabetes. Stopping these medicines can reverse such type of diabetes. Now let's have look at type 2 diabetes. It generally occurs in the obese and adult patients. Multiple factors play role in the development of it. These are genetics, family history, obesity, resistance to insulin action, a defect in the hormone called incretin and problem with glucose handling at the liver, kidney, and muscle. Not all the factors are reversible. So it seems that type 2 diabetes is also irreversible. But in the recent years' research has provided rays of hopes to the reversal of type
2 diabetes.

The studies have found that weight loss can lead to a reversal of type 2 diabetes at least for some time in few of the patients. The extent of the reversal of diabetes depends upon the amount of weight loss and method adopted for the weight loss. Bariatric surgery in which part of stomach and intestine is removed has shown significant improvement in diabetes with a subset of the patients of the medicines. Though weight loss has proven as a promising tool for diabetes management it has not become standard therapy to reverse or cure diabetes. There are multiple reasons for it.

First -These are the clinical studies where a patient is motivated and strictly follow diet advice. This is not possible in every case in routine life.
Second - Maintaining the significant weight loss over a long duration is difficult.
Third - Even after doing bariatric surgery if a patient continues the previous lifestyle he/she can not be cured of diabetes.
Fourth- Diabetes is not just because of the obesity. There are other players in the development of diabetes. Hence even someone achieves weight loss these other factors can lead to persistence of diabetes.

So what science says about diabetes reversal?
At present certain type of diabetes like type 1 diabetes, pancreatic diabetes, diabetes with the genetic syndrome cannot be reversed. Diabetes secondary to drugs can be reversed after stopping the culprit drugs. Type 2 diabetes can be reversed in some patients (not all) if they achieve healthily
sustainable weight loss.

So what patient should do?
Adopt a healthy lifestyle and do exercise as per your doctor's advice.
DONT STOP MEDICINES ON YOUR OWN and lastly don't play with your health as there are other good games than your health to play.....DONT STOP MEDICINES ON YOUR OWN and lastly don't play with your health as there are other good games than your health to play.....
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