It was explained to me that if I do everything right, the best case is that all of the horrorible consequences of diabetes can be postponed till I die of something else. If I lose 100 lbs I might well be able to get off some of the drugs.
But, as explained, I cannot get better. I will always be a diabetic, always have a whippy pancreas, never be able to eat with impunity. If I lose 100 lbs I will be a thin diabetic. I might even become a physically fit diabetic. Dare I say, an aerobic diabetic. But always a diabetic.
So is that true?
The reason I ask is that I am trying to explain to my girlfriend that she needs to be 100% aware of what she is getting into with me, and should not hold out expectations that I will "diet and exercise" my way out of this.
Let me allow a simplification: T2 means your cells are less sensitive to insulin (insulin resistance). This means you need to produce more insulin to compensate that. A healthy body can produce 25 IU of insulin per hour. If your insulin needs are exceeding this limit you will have less insulin in your blood than needed. This will of course stress your beta cells (they are producing the insulin). After a while more and more cells will die from the stress. The solution is to stop this from happening. The insulin resistance needs to be adressed first. Metformin for example is a good medication to reach a higher sensitivity for the insulin that is produced. Secondly you have to think how the limited capability to produce insulin should be adressed. We need insulin for every cell of your body. The more cells we have the more insulin is needed. Thus the body weight is another key to success. If you reduce your body weight by 30% you will have more insulin for the rest of your body. Furthermore the capability to utilize insulin can be increased with more physical activity. This means the insulin is better used. If the higher activity leads to a better ratio between fat and muscles your basic metabolic rate will increase. This means more glucose is consumed by the muscles. All that can lead to a situation that is similar to being healthy - not healed from the metabolic impact of T2 but similar. Coming off medication should be the last goal because the insulin resistance needs to be adressed for the rest of your life. Otherwise the cycle can repeat itself.
The simple answer is yes, you will always be diabetic. the question to to be seen will be the types of treatments you need to manage good blood sugar and it is at least possible your treatments will change over the duration of your life. on the plus side, diet and exercise can lead to the need for less or no medications. Keep in mind as Holger states, getting off of meds shouldn’t be the priority, keeping healthy BG is the number one priority. On the other side, the disease can be progressive so what works now may not work in 5 year or 10 years. Depending on how you mange your BS, you could see a loss in beta cell production meaning less insulin is produced to meet the needs of our already resistant cell. That could result in increase in the need for oral or shot treatments. Unfortunately is the big unknown in this disease.
For a great resource, i would check out bloodsugar101 (the book or website). its a great starter resource on managing the disease with a wealth of information, particularly for those recently dx’d. it would also help for your GF to read the book. I had my wife read it a couple month after my dx and it really helped her to understand whats involved with the management of the big D.
You can be “better” insofar as your blood glucose can stay within a healthy range if you do what is necessary re: diet & exercise & so forth. You won’t get better if by “better” you mean able to eat a standard American diet and be a couch potato without health consequences. You have diabetes. That’s not going to change, although you can make changes so that the diabetes has much less impact on your life.
But your girlfriend is not getting “a diabetic,” she’s getting YOU. Diabetes is not who you are. Diabetes may impact how you behave, and yes, she needs to understand that it’s part of the package, and that sometimes (often!) it sucks, but please bear in mind that it’s not the whole thing. The sucky parts are balanced out by the wonderful parts. I would never trade my little boy in for a healthy model, even though I’m currently sleep deprived and pining for a night that doesn’t include blood sugar testing. And anyone who is worthy of a committed relationship will feel the same.
When I was diagnosed, I thought that I might be able to fix my diet and exercise and be able to restore normal blood sugar levels for a while, perhaps indefinitely. I was about 20lbs overweight and not particularly active. Perhaps a not unreasonable thing? Initially, I had some success, I dropped by HbA1c down to 5.7% with just diet and exercise and metformin. It seemed like success. But, I was wrong. My blood sugar control has degraded over the years despite all my efforts and I have pretty much given it the ole college try. The medications never worked for more than a few weeks.
I’ve accepted that my diabetes is not a result of my being overweight and a sloth. Perhaps some diabetics will find that their condition is highly aggravated by being overweight and they can eat better, exercise and make it go away, but for most of us, that will never be true. You are overweight because you are diabetic, not the other way around. Eating the strictest diet and exercise won’t put my diabetes into remission and today I am to the point where even with three maximum medications, Bernstein diet and weight training, I am barely able to maintain blood sugar targets.
But that does not mean that I have to accept all of the complications of high blood sugars. And I won’t. I’ll just be starting insulin, and that is fine. And I’ll be living my life to keep my blood sugars under control and minimize my risk of complications. I already suffer some minor complications and I may have more in the future, but stuff happens. There are all kinds of health risks. What matters is the choices you make in your life. With diligence and good control, any diabetic (t1 or t2) can reasonably expect to live a long, happy and healthy life.
Who are you to question whether you are “damaged goods” as a diabetic. How do you know that being diagnosed has not changed your life for the better, making you an aerobic diabetic who will now live longer? And give your girlfriend some credit for make her own decisions. I mean look at me, my wife chose to marry me despite my big ears and goofy face.
I’m just recently dx’d myself bcs, but that is totally my outlook. my first “goal” when i got the news was to get off the meds.But once I got adjusted to my new condition, and i read, and read, and read, i realized the number one thing i can do is keep my blood sugar in good range. i shoot for <130 1 hour postprandial, and <100 2 hour postprandial. if that means exercise… great, diet…wonderful, Oral meds…you got it. And if it takes insulin to eventually manage my targets… I’m OK with that too. For me it just easier to focus on that goal, and work everything else into my treatment.
JeffD, you can manage this. its a hell of a commitment and take a lot of work. Diabetes s a unique disease as it is a life long commitment. Our friends, significant others, co-workers etc can support us, but until you have a lifelong chronic illness, you really cant relate. That said, particularly family members have their own issues in supporting a loved one with D. But to manage your disease, its up to each one of us (at least those old enough ;-)), to be our own advocate, take ownership of our disease and mange it in the best way we see fit.
Your control can improve heaps. It doesn’t even need to be 100 lbs… In my experience, since I weighed about 248 lbs when I started this, once I lost like 30 lbs, things were much better… My highs now are not as bad as they used to be… But I still cut back on carbs a lot.
We all hope that we w ill be cured if we do this or that…we all hope that a cure will be found. You can make things better as everyone has told you here, but as far as healed forever, don’t count on it. Work for healthier more so than cured at this point.
This is not the death sentence that everyone who isn’t faced with “D” thinks. There are people world over who have learned to live, thrive, and be very successful treating their “D” and in their lives. Mary Tyler Moore, Patti Labelle are two that come to my mind immediately, very successful in all aspects of their lives. If our loved ones knew “what they were getting into” totally what would change. They can’t understand what having “D” means to a person, unless they are one themselves. All they can do is have a degree of understanding and support for their family member. With this disease you can do all the things right and have things go wrong, you can do all the wrong things and have things be right. Be the best you can be…work towards health and a diabetic normal…that’s the best you can do for you.
By the time one reaches a T2DM diagnosis, it is said that one has lost 50% - 80% of one’s beta cell function, which is irretrievable. OTOH, when obesity enters the equation, one must also pay attention to the lipokines (hormone-like chemicals) produced from fat cells. Some of these lipokines are directly responsible for insulin resistance and/or decreased glucose tolerance. I believe that it is possible that some cases of what we call “diabetes” are caused by a level of lipokine production much higher than researchers have routinely measured, causing significant hyperglycemia well before there is significant permanent beta cell damage. In these cases, sufficient weight loss can restore semblance of normal glycemic function for a period of time, but only as long as that weight loss is maintained.
A person with type 2 can get better. Cured not really. I was diagnosed 7 years ago as what I dont know because the doctor never bother to tell me what I was. I was on insulin, Lantus and Humalog using a step scale. For a year a lost about 40 lbs and did not have to use insulin. I was off meds for about 2 years until I stopped eating healthy and stress levels picked up then I wound up on metformin 2000 mg a day and januvia 100 mg a day. All those drugs were killing my stomach and my mind. So I turned to what I loved the most which was cycling. I pushed my self first a couple of miles at a time and then up to 10 miles a day and hold steady at 10 a day. It has helped me get my bg’s lower and i am down to 1000 mg metformin a day. Takes work with diet and excercise but on a good 15 mile ride I can eat a couple of slices of pizza before I take off.
The intersting thing is I dont think any of our wives/husbands/partners are 100% aware of what they got themselves into with a diabetic person. I am still not 100% aware. I amaze myself sometimes and sometimes I wonder why things go a certain way. Some days are good and some are bad with no reason as to way things are different when you do the exact same thing.
So it is true you will be some form of a diabetic but you will be a diabetic.
