Is It Possible to Reverse Diabetes? Answers to FAQs.
10 min read
Q: How do I know if I have diabetes?
A: Common symptoms of diabetes include excessive thirst, a constant feeling of hunger (especially after eating), and frequent urination. If you are experiencing these symptoms — especially if you have a family history of diabetes — visit your doctor. He or she will examine you, take note of your health history, and run tests of your blood glucose level to possibly arrive at a diagnosis. If you have a fasting plasma glucose of 126 mg/dL or higher or an A1C of 6.5 or higher, you have diabetes.
Q: Does sugar cause diabetes?
A: Not really, but diabetes has everything to do with how your body handles the sugar you consume. Diabetes mellitus is a group of metabolic disorders that cause the level of glucose (sugar) in your blood to be too high. This is called hyperglycemia.
If you’re diagnosed with a type of diabetes, you will likely have to cut down on the amount of carbohydrates (particularly sugars and starches) that you eat and drink, specifically in the form of beverages with added sugar. In order to keep your blood glucose level stable you may need to count the carbohydrates you consume, take insulin or oral medication, and monitor your blood glucose. With proper balance and smaller portions, sugar and other carbohydrates can and should remain a part of your diet.
Q: Which is worse: type 1 diabetes or type 2 diabetes?
A: Both are conditions with life-altering symptoms and complications, but they have very different causes. Type 2 diabetes is caused by insulin resistance, when the body stops responding well to insulin and the blood glucose level rises too high.
It’s typically diagnosed in people older than 45. Whether or not you develop the disease depends on a combination of risk factors under your control, including diet, exercise, and lifestyle; as well as those you can’t control, such as genes, family history, age, and ethnicity. Even if you do have one or more risk factors, it’s possible to reduce your risk of developing type 2 diabetes by sticking to a healthy diet and lifestyle.
But type 1 diabetes is the result of an autoimmune disorder in which a person’s own immune system attacks and destroys the insulin-making cells in the pancreas. Without that hormone, the blood glucose level rises too high and insulin injections must be taken daily to replace the insulin that the body doesn’t make.
It typically appears in teenagers and young adults, and researchers don’t believe it’s preventable. “Autoimmunity in type 1 diabetes is unavoidable for those who get it,” says Miller.
Q: Is type 2 diabetes genetic? What about type 1 diabetes?
A: Both type 1 and type 2 diabetes are polygenic, meaning they involve multiple genes, and their development is affected by lifestyle and environmental risk factors.
A fledgling field, called polygenic risk scoring, looks at common genetic variations known as single nucleotide polymorphisms (SNPs) that may be associated with your risk of developing type 1 or type 2 diabetes.
Nonetheless, risk scoring cannot tell you with certainty if you will develop one of the disorders. Family history is another risk factor, but it’s hard to know whether that is due to sharing genetic variations with relatives, or also due to having a diet, lifestyle, and environment in common.
Q: What does “prediabetic” mean?
A: If you have prediabetes, it means your body has stopped responding well to the hormone insulin — a condition known as insulin resistance — and your blood sugar is higher than normal, though not high enough to qualify as diabetes. If you don’t reverse the trend through changes in diet, exercise, and lifestyle, you may eventually develop type 2 diabetes.
Family history, advancing age, excess weight, and a sedentary lifestyle are among the known risk factors for developing insulin resistance.
One way to know if you have prediabetes is to take a hemoglobin A1C test, which measures how much glucose attaches to the hemoglobin in your red blood cells, on average, over the previous three months. A normal A1C result is below 5.7 percent. If your A1C is 5.7–6.4 percent, then you have prediabetes. At 6.5 percent or above, you have diabetes.
Q: Can people with diabetes donate blood?
A: Yes, it is possible to donate blood, with a few caveats. “I want them to have their blood sugar under really good control,” says Derocha. Not only is that important for the health of the individual — since donating blood (along with the glucose it contains) removes a small amount of fuel from your system — but it is a requirement of the American Red Cross.
Taking oral medications and most forms of insulin to maintain that control is okay, but if you have ever used bovine (beef) insulin made from cattle from the United Kingdom since 1980, you are ineligible, because of a concern about Creutzfeldt-Jakob disease, also known as “mad cow disease.” If you’re in doubt about your blood sugar level or what insulin you have taken, check with your doctor.
Q: Can people with diabetes eat fruit?
A: If you have diabetes, you absolutely can eat fruit in moderation and paired with other types of nutrients. First, look for fruit options lower on the glycemic index (GI), says Turkel. The GI is a measure of how food raises blood glucose levels. Foods are ranked on a scale of 0 to 100, with 100 being the GI of pure glucose (sugar). Most fruit is low on the GI, at 55 or below. Looking at the glycemic load, a related measure that compares how the same amount of carbohydrates in each food will raise your blood sugar, gives an even better picture of how fruit or any other food with carbohydrates will affect your blood sugar.
“At one given time you don’t want to have more than 1 cup of cut-up fruit or a cup of berries or one small piece of fruit,” Turkel advises. “And you never want to eat a piece of fruit or cup of fruit without a protein or a fat.” Adding protein or fat slows down the impact of the fruit’s sugar in your bloodstream and lessens the chance of a spike in blood sugar. “If you like fruit, pair it with some protein — a handful of nuts, a hard-boiled egg — and be strategic about it. And limit it to only twice a day.”
Q: What is a “diabetic diet”?
A: If you’re diagnosed with diabetes, you may receive a meal plan that involves keeping track of the amount of carbohydrates (which include sugars, starches, and fiber) in your food and drinks. You will be encouraged to count carbohydrates and keep them at a consistent level for each meal you eat to help stabilize your blood sugar. Your healthcare team can help you decide how many carbs it’s safe for you to take in each day. They’ll take any medication or insulin you’re on into account. But it’s good to know that the recommended amount of carbohydrates for most people with diabetes is about 50 percent of total calories consumed.
Q: What foods should people with diabetes avoid?
A: There are very few foods that a person with diabetes ought to totally avoid. If you practice portion control, count your carbohydrates, and eat a healthy balance of nutrients, you should be able to continue eating many of the foods that you like — in moderation. “I don’t believe in taking away foods from patients. Instead, I believe in educating them in how to appropriately eat the foods,” Turkel says. But, she adds, “if they are drinking juice and regular soda, and sweetened beverages like that, that is one thing that I do recommend they cut out. That’s an easy fix.” You’ll also want to limit your intake of processed food that is high in salt, sugar, and saturated and trans fat.
Q: Can people with diabetes get tattoos?
A: Yes, but you should check with your doctor first, and be sure of a few things, says Derocha. “Obviously you would not do this if you were pregnant [and have gestational diabetes], but with type 1 or type 2, you’d really have to have good blood sugar control. That is because one of the side effects of poor sugar control is an inability to heal [well] and to fight off infection.”
She also cautions against having tattoos if you have kidney problems or diabetic peripheral neuropathy (nerve damage), particularly in the regions where you want to place the tattoos. Again, this is to guard against the possibility of an infection that will sicken you or heal poorly, according to the Cleveland Clinic.
Q: What is diabetes insipidus?
A: This condition is unrelated to type 1 or type 2 diabetes. Instead, it’s caused by an inability of the kidneys to balance fluid in the body, according to the NIDDK.
As a result, the body excretes large amounts of urine. In this condition, blood glucose levels remain normal.
“It presents as excessive urination, and extreme thirst (similar to diabetes mellitus), but it’s actually a result of inadequate output of a pituitary [-released] hormone called antidiuretic hormone,” says Turkel. Also known as vasopressin, the hormone controls the kidneys’ fluid removal rate through urination.
Q: What does diabetic nerve pain feel like?
A: Diabetic peripheral neuropathy, or nerve damage, can develop when elevated blood sugar damages nerves, which then send sensory signals to the central nervous system in an altered and disordered fashion. The result can be neuropathic pain that is burning or tingling in nature, according to the NIDDK.
After the condition is diagnosed and blood sugar is brought under control to prevent further nerve damage, your healthcare provider may prescribe over-the-counter or prescription medication for the pain. In rare cases, you may undergo electric nerve stimulation to alleviate symptoms.
Q: Can dogs get diabetes?
A: Yes, they can. Like us, they can develop insulin deficiency diabetes (which is like type 1 diabetes in humans), and insulin resistance diabetes (which is like type 2 in people). The insulin-deficient type is most prevalent in canines, though older, obese dogs in particular can develop insulin resistance. The symptoms and treatments of diabetes in dogs are not unlike what humans experience. Breeds that may be at higher risk for the condition include miniature poodles, bichons frises, Australian terriers, fox terriers, cairn terriers, pugs, dachshunds, miniature schnauzers, pulis, Samoyeds, keeshonden, and beagles, according to the American Kennel Club.
Q: Can you die of diabetes?
A: Yes, and in fact diabetes was the seventh leading cause of death in the United States in 2017, claiming nearly 84,000 people, for whom it was the underlying cause of death listed on their death certificate.
People with type 1 diabetes have an average life expectancy of 68.6 years, which is 12.2 years less than the average life expectancy overall, according to an Australian study published in the June 2016 issue of Diabetologia.
In both type 1 and type 2 diabetes, the long-term damage caused by elevated blood sugar can lead to heart disease, stroke, kidney disease, nerve damage, and other life-shortening complications.
Q: Can diabetes cause low blood sugar?
A: Yes, having diabetes can lead to sudden drops in blood sugar, also called hypoglycemia. These drops can occur when your insulin or medication dosages don’t align with your eating and exercise habits. Hypoglycemia can also be caused by missing a meal or not having enough carbohydrates in a meal.
Signs that your blood sugar has dropped can include feeling shaky or jittery; having blurred vision, fatigue, dizziness, disorientation, fast or irregular heartbeat; being irritable; and feeling weak or extremely hungry. If left untreated, hypoglycemia can result in unconsciousness and seizures.
If you have diabetes, check your blood glucose if you notice any of these symptoms and if your number drops below 70 mg/dL (or the target you’ve set with your doctor), and then take in 15 g of carbohydrates right away, and then check your blood glucose 15 minutes later. Repeat this until your blood glucose is on target. This is called the rule of 15s. If it doesn’t help you meet your target after several attempts, use oral glucose.
The best way to avoid hypoglycemia is to check your blood glucose regularly, eat regular meals with the right amount of carbohydrates in them, and note any adjustments you might need to make in what you eat or how much insulin you take when you exercise.
Q: Can diabetes be reversed?
A: Insulin resistance (which is seen in type 2 diabetes and gestational diabetes) is much easier to reverse in the prediabetes stage, says Happel. Lifestyle changes can help you to get your blood glucose back within normal range, including: a healthier diet; smaller, more frequent meals to keep your blood glucose stable; regular exercise; and weight loss.
Once you have developed type 2 diabetes, it’s much harder to get your blood sugar back into normal range, though you can certainly lower it with diet, lifestyle modifications, and medication, says Happel. “When they get to the point where they need insulin, it’s harder to reverse, but it can be [reversed].” Bariatric surgery (weight loss surgery) has helped some obese people with type 2 diabetes to regain normal blood sugar levels and stop taking diabetes medication, according to the NIDDK.
Yet once your A1C passes 8, you’re less likely to be able to reverse the condition, Happel says. “What is happening is that your pancreas is starting to burn out,” she explains, after which you will definitely need insulin for the foreseeable future.
For those who have had gestational diabetes, the insulin resistance usually reverses after the child is born, but notably, half of all women with the condition during pregnancy will go on to develop type 2 diabetes later in life.
Currently, there’s no practical way to get rid of type 1 diabetes or cure it. Thus, for now, these individuals must take insulin for life. According to the NIDDK, in a limited number of cases, people have undergone transplantation of pancreatic islets (cell clusters that include the insulin-producing beta cells) from a deceased donor, but scientists still consider this an experimental procedure, with the same risks and expenses that are associated with organ donation.
“Not realistic. Not very effective,” at this point in time, comments Miller, who is nonetheless hopeful that research into beta cell regeneration and transplantation will bear fruit in the future.
Source: Everyday Health.
