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Every year in the United States, 1.5 million people are diagnosed with diabetes, and it’s the seventh-leading cause of death, according to the American Diabetes Association. Can diabetes be cured? Let’s first consider the two main types:
- Type 1 (or juvenile) diabetesaccounts for 5 percent of all cases.
- Type 2 (or late onset) diabetes mellitus accounts for 95 percent of all cases.
Both types of diabetes affect the body’s ability to make or use insulin. Insulin is a hormone that controls the metabolism of sugar and fat in the body. It stimulates glucose uptake by cells and lipid synthesis, plus it inhibits the breakdown of lipids, proteins, and glycogen, and inhibits the production of glucagon and ketones.
Can Type 1 Diabetes Be Cured?
Type 1 diabetes is an autoimmune disease in which the immune system attacks the pancreas, reducing the body’s ability to make insulin. It develops most commonly in children and young adults and is a lifelong condition. There is currently no cure for type 2 diabetes. Treatment focuses on insulin replacement for life.
Can Type 2 Diabetes Be Cured?
Currently, type 2 diabetes cannot be “cured,” but some sufferers can go into remission for a period of time, meaning that their blood sugar is in the normal range. The underlying condition remains, however, and the individual is always at risk of relapse. In the rest of this article we’ll be talking about type 2 diabetes.
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Types 2 Diabetes Complications
Type 2 diabetes is due to decreased insulin sensitivity and the body not making enough insulin. This results in high blood sugar (hyperglycemia) and abnormal lipid levels in blood.
If left untreated, diabetes damages cells, organs, and systems in the body leading to a whole host of problems, including:
- Cardiovascular disease
- Nerve damage (neuropathy)
- Kidney damage (nephropathy)
- Eye damage (retinopathy)
- Foot damage (including ulcers and gangrene)
- Skin infections
- Hearing impairment
- Increased risk of Alzheimer’s disease
These complications lead to an increased risk of premature death.
What Causes Type 2 Diabetes?
In order to reduce symptoms and possibly trigger remission, it’s important to understand what causes diabetes. According to experts at National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the cause of type 2 diabetes mellitus is a complex interaction between environmental and genetic factors, including:
- Obesity (about 90 percent of those with type 2 diabetes are obese)
- Family history of diabetes
- High-calorie diet
- Inadequate exercise
- History of hypertension, prehypertension, heart disease, or stroke
- Age 45 or older
- Race (African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander’s are at increased risk.)
- High level of triglycerides (“bad” fats) and low levels of HDL (good fats)
- History of gestational diabetes or have given birth to a baby weighing 9 pounds or more.
How Lifestyle Changes Affect Diabetes
While family history, age, and race can’t be changed, lifestyle changes can:
- Reduce the risk of developing the disease
- Reduce the impact in existing disease
- Trigger a long-lasting remission
Sufferers will need to monitor blood sugar levels daily and also monitor symptoms, cholesterol, and weight regularly.
Diabetes: Diet Considerations
A healthy diet may help return and maintain blood glucose level to the normal range.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and many other physician groups recommend eating a variety of foods from all food groups: non-starchy vegetables, starchy vegetables, fruits, whole grains, lean protein, healthy fats, and dairy. They recommend portion control and calorie counting, and also limiting the following:
- Foods rich in saturated fat and trans fat
- Foods high in salt
- Foods rich in sugar and refined carbohydrates, such as baked goods, candy, and ice cream
- Drinks containing added sugars, such as soda, juice, sports drinks, or energy drinks
The NIDDK also recommends “carbohydrate counting”—that is, keeping track of what you eat. If you’re looking for a diet to follow, a Mediterranean-style eating plan or DASH diet have been extensively researched and shown to improve health.
A 2017 article in the journal Diabetes Care explains that the goals for dietary change should be “healthful eating patterns emphasizing a variety of nutrient-dense foods in appropriate portion sizes.” Additional goals include achieving a healthy weight; attaining healthy blood sugar, blood pressure, and lipid levels; and reducing complications. The authors emphasize developing an individualized plan based on “personal and cultural preferences, health literacy and numeracy, access to healthful foods, willingness and ability to make behavioral changes, and barriers to change.”
Some research, however, suggests a more drastic dietary change. A 2017 literature review concluded that “whole-foods, plant-based diet—legumes, whole grains, fruits, vegetables, and nuts, with limited or no intake of refined foods and animal products—are highly beneficial for preventing and treating type 2 diabetes.” A 2018 study found that overweight people who switched to a vegan diet for 16 weeks showed improvements in insulin sensitivity compared to a control group.
Other experts, including Dr. Mark Hyman, the Medical Director at Cleveland Clinic’s Center for Functional Medicine, recommend the restriction of dietary sugar and processed foods. In his book The Blood Sugar Solution, Dr. Hyman lays out a strategy—changing diet and improving nutrition—that has helped many people control diabetes.
Exercise: Key to Prevention and Treatment of Diabetes
Research has shown that physical activity combined with modest weight loss can reduce the risk for type 2 diabetes by up to 58 percent.
Physical activity increases energy/glucose use. A structured exercise programs of at least eight weeks has been shown to improve blood sugar control. Exercise also reduces body mass index (BMI), improves cardiovascular fitness, enhances muscle strength, and improves insulin sensitivity and mobility.
The U.S. Department of Health and Human Services recommends that adults “engage in 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity, or an equivalent combination of the two. Additional recommendation: muscle-strengthening activities that involve all major muscle groups two or more days per week.
Always see your doctor when starting a new exercise problem if you have medical problems; he or she will advise you on what is safe and what to avoid. You also will need to drink plenty of water and monitor your blood sugar more closely, as exercise may impact its control.
Sedentary time should also be reduced for people with diabetes: Try some light movements such as standing or walking or even doing chores every 30 minutes or so.
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The combination of diabetes and excess body weight puts individuals at high risk of complications. For people who are overweight or obese, a five percent reduction in body weight has been shown to improve glycemic control, lipids and blood pressure and to reduce the need for medication. Weight loss always sound easy: Just eat less and exercise more. If only it were that simple! There are numerous reasons why people struggle to lose weight including mindset, practical problems (like a busy lifestyle or limited access to healthy food) and stress eating. Many benefit from joining a support group, advice from a dietician or using online tracking applications such as the Body
Weight Planner or the SuperTracker.
Gastric band and gastric bypass surgery may be useful for people who have been unable to lose weight, despite a concerted effort. As with any surgery there are risks involved, so it is not a first-line treatment.
Is There a Cure for Diabetes? A Future Play
While there is currently no cure for diabetes, researchers are hopeful for advancements. A 2017 pilot study may provide hope for a diabetes cure in the future. Researchers found that an intensive metabolic intervention, combining personalized exercise routines, strict diet, and glucose-controlling drugs could achieve partial or complete remission in 40 percent of patients, who were then able to stop their medication. More comprehensive studies are in the pipeline.
General advice to people with diabetes: Stop smoking, seek psychological support if needed, keep up to date with immunizations, and treat complications promptly.