Diabetes

14 November 2017

Can diabetes be cured?

A diabetes educator sets out to clear up the misconceptions around living with, or even 'curing', diabetes.

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Being diagnosed with diabetes is often overwhelming for a person. Living with it can be just as hard.

Hamish van Wyk, registered dietitian and diabetes Educator from the Centre for Diabetes and Endocrinology (CDE), says there is so much misinformation regarding how best to live with, or even "cure", diabetes. Van Wyk says before addressing that point it is important to unpack the difference between type 1 diabetes and type 2 diabetes.

Fat around the waistline

Type 1 diabetes affects around five to 10% of people with diabetes and is an autoimmune condition whereby the body attacks the insulin-producing beta cells of the pancreas. This results in people needing insulin from the day of diagnosis to ensure healthy blood glucose levels. At this stage, it unfortunately cannot be cured.

Type 2 diabetes, on the other hand, affects the biggest group of people – approximately 90 to 95% of those with diabetes. It is largely associated with lifestyle factors including urbanisation, Westernisation, inactivity, being overweight and unhealthy patterns of nutrition, which express an underlying genetic predisposition.

Van Wyk says that fat distribution is particularly important – too much fat around the waistline (central, visceral or abdominal obesity) is both the initial cause and the continuing driver of an ongoing vicious cycle of dysfunctional metabolic processes.

These result in declining production of the blood glucose lowering hormone insulin, resistance to the effects of insulin and deposition of excess toxic fat in the liver and pancreas. This situation leads to an increasing need for therapies to manage diabetes, including eventually, insulin therapy.

The big question is, can type 2 diabetes actually be cured? “The simple answer is no,” says van Wyk. “The damaged cells in one’s pancreas will always be damaged. One can however reduce or even cure insulin resistance and you can put type 2 diabetes into remission. 

“As with cancer, type 2 diabetes can be put into remission – medication will no longer be required and the person’s blood glucose levels will remain normal.”

Very low-calorie diet

Van Wyk says, “Despite remission being possible, it is often not achieved through conventional moderate calorie restricted diets, where only 11.7% of people go into remission. However, through very low calorie diets (<800 calories a day) we see a very different picture – remission can be achieved within one week! It appears that the key is the very low calorie content of the diet.”

The latest published data from 2016 shows that after eight weeks on a very low-calorie diet, up to 87% of people who had diabetes for less than four years, went into remission.

“The length of time one has had diabetes is very important, and unfortunately this fact is not coming across in consumer articles. If you have had diabetes for 10 years or more, you are less likely to go into remission even if you follow a strict nutritional regimen. Around 50% of these patients achieve remission,” he says.

Nevertheless, even if one can’t go into remission, the research shows that by following a very low calorie diet and using the "break" to re-establish a new and healthier relationship with food, you can still benefit from huge reductions in insulin and or oral medication while improving your weight and blood glucose levels.

Find out more about how to put diabetes in remission.

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Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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