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August 9, 2022

Prediabetes Remission

Prediabetes remission means that the blood sugar levels of people with prediabetes have lowered to a normal, healthy level without taking diabetes medication. People with type 1 diabetes cannot currently put their diabetes into remission.

Technically, diabetes remission is defined as when a person with type 2 diabetes’ HbA1c results (average blood sugar levels over two to three months) are in the ‘normal’ range (below 6.5%) for at least six months.

Prediabetes remission

For prediabetes, this follows that HbA1c results (average blood sugar levels over two to three months) are in the ‘normal’ range (below 6.0%).

However, diabetes remission is a fairly recent idea so further research is required to fully understand the concept. There is no evidence to show that remission is permanent, so it must be maintained and managed to prevent developing type 2 diabetes again.

What does the evidence say?

The strongest evidence available shows that weight loss is the best way to enter diabetes remission.

If you are obese, losing around 15kg quickly and safely is the most effective way to enter diabetes remission after being diagnosed with type 2 diabetes.

Not everyone who has type 2 diabetes are obese; for example, age, ethnicity, and family history all increase the risk of type 2 diabetes. Therefore, weight loss is not recommended for people who are a healthy weight, under 18, have history of an eating disorder, or are pregnant or breastfeeding.

Carrying weight around the middle means that fat builds up around organs, such as the liver and pancreas, which affects how well these organs work and leads to type 2 diabetes. Research is being conducted into whether losing weight helps the liver and pancreas work properly again.

Research also shows that losing 5% of body weight can not only lower your blood sugar levels, but also your blood pressure, and cholesterol levels.

Weight loss also reduces the risk of other serious health conditions, such as issues with your eyes, feet, and heart, and means that people may also need less medications. Nevertheless, there is not sufficient evidence to prove that remission reduces complications, so regular checks are essential to maintain and treat existing or new complications.

Can I re-develop prediabetes?

It is always possible that remission can develop back into type 2 diabetes if your blood sugar levels rise again, so remission should be maintained by staying a healthy weight and keeping Hb1Ac levels below 6.5%.

Health checks at least once a year, including a retinal screening, are also important so healthcare professionals can keep an eye on blood levels, and offer support if blood levels rise.

Although remission is more likely if you lose weight soon after type 2 diabetes diagnosis, some people can enter remission after 25 years.

Research suggests that the best natural ways to enter remission both involve losing weight - either through a low carbohydrate diet, ketogenic diet, Mediterranean diet or a low calorie diet.

The other way is weight loss or bariatric surgery which makes you feel full quicker and reduces how much you eat.

Which option is best for me?

Different methods work for different people.

It is key to remember that surgery is not a quick fix but is an option. Whichever method you choose, it is vital to seek support from and speak to healthcare professionals to make sure it is right for you.

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