can you reverse diabetes

[rootietootie]

Hi, thanks for your time to answer questions.  I wanted to know if in prediabetes (insulin intolerence by cells)  if it can be reversed.  Can the damage done to the pancreas be reversed , or when b cells die, they never regenerate?  Could a sudden weight gain of 20lbs make someone develop diabetes (perhaps they had prediabetes before without knowing it)  If you have prediabetes and then you get diabetes can that be reversed or once it is diabetes, that is it.  Thanks so much , I appreciate your time.  Shannon

[Anita Ramsetty, MD]

Hi Shannon,
Thanks for your questions.
1)prediabetes can be reversed in most people, depending on what caused it. If you are on your way to being a Type 1(where your beta cells have died) then it is not reversible. But if you are headed towards Type 2, then most of the time it can be reversed.
2)A damaged pancreas does not regenerate, so once those beta cells are gone, they are gone for good. They can be "toxic" and resume normal function after a while, but otherwise there is no regeneration.
3)Sudden weight gain can certainly cause someone to develop pre-diabetes or tip them over into full blown diabetes.
4)Diabetes can be reversed at times through weight loss and exercise--I have many patients who have done it on their own. If it was caused by medications, it can also often be reversed by stopping the medications.
Hope this answers your questions! Take care.

[Busha906]

Hello,

I'm a bit confused.  At thehe diabetic classes I attended, the nurse said if you are a Type 2 diabetic you will remain so, even if at some point you need to go on insulin.  You comeents differ.  It's all so complex!  

Thanks for your input,   Busha906

[LissaC]

I'm confused too... what do you mean by reversed?  If you are a type 2 diabetic, you will always be one. You can't back up and and stop being diabetic.  You CAN slow down the progress of the disease, keep tight control of your numbers, reach a point with diet and exercise where you can stop taking medications for a while, but you have to be willing to seriously work at that. And that doesn't mean it's been reversed, you are still diabetic and it isn't going away.

[rootietootie]

I think that what she means, if your beta cells are still functioning (type2) and have not all died off (type1) if you find the root cause that can be changed, (not heredity) things like being overweight and diet , and you changed them, being of normal weight and eating right, and getting plenty of exercise then you can overcome the disease in terms of getting off your medications.  I know some doctors say it cant be cured because even if you improve it , it can come back when you gain weight again, or start eating bad, or become inactive.  But from the reading I have been doing, it really can be reversed.   Do some googling on Insulin resistance on a cellular level.    The questions I have are 1: Why does your disease continue to progess? (are beta cells continuing to die off because of damage?)  If this is the case why does it continue to happen?  If that is happening and beta cells are dying then you could be a type 1 some day. 2) What can you do if anything to keep furthur damage from occuring to avoid your diabetes getting worse?  3) what does cellular insulin resistance mean and how can I make my cells more open to insulin, and if I were able to do this, how would it affect my diabetes?  These are questions to ask your doctor, and to look up on the internet.  I think there are ways of eating and exercising to reverse insulin resistance, which is a major cause of diabetes.  Please dont just take what some doctors and nurses tell you that it will never go away, and you will be on insulin someday.  Try to fight this the best you can.  Diabetes can be so incredibly damaging to the body, dont just go with it, fight it.  Shannon

[Anita Ramsetty, MD]

Hi,
To clear up the confusion:
No, I do not believe that once you have the diagnosis of diabetes, you are then on that path towards insulin forever-- Not in the case of Type 2 atleast. I have many patients  who had their blood sugars return to normal through diet and weight loss. The LABEL changes from "diabetic" to "history of diabetes". If your  blood sugars are normal and A1C is normal(less than 5), you do not have diabetes anymore. It may come back(chances are good for many it will) but it may not.
Individuals who have diabetes from medications can also return to normal after the medication is stopped. Many people with Type 2 are diagnosed late and that makes it less likely they can return to normal, so instead they aim for control without further progression.

[colmack]

Hi,
You refer to drugs that may induce Type2, what are they and what alterative treatment could be suggested?
Thanks,
Colin

[Anita Ramsetty, MD]

Hi Colin,
There are a number of medications that can cause diabetes in different ways. Some common ones include steroids(like prednisone, decadron etc), Niacin for high cholesterol, and some blood pressure pills. Some less common ones include anti-rejection medicines taken by transplant recipients.  The list is actually long, so it is best to ask your doctor about possible effects on glucose before starting a new medication. They should let you know this is a potential side effect.  You should know though that most have a "tip you over" effect where they make your blood sugars high if you were leaning in that direction already. Not many will push you from completely normal to abnormal sugars.
Hope this answers your question.
Take care.

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