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Is diabetes always diabetes?

A Akinmokun1, P Harris, P D Home

  • 1Department of Medicine, University of Newcastle upon Tyne, Medical School, UK.

Diabetes Research and Clinical Practice
|November 1, 1992
PubMed
Summary
This summary is machine-generated.

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Many people with diabetes can achieve normal glucose tolerance through diet and weight loss, challenging the lifelong diagnosis. This suggests a review of diabetes diagnostic criteria is needed for those maintaining healthy habits.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Clinical Nutrition

Background:

  • Diabetes mellitus is typically considered a lifelong condition.
  • Lifestyle interventions, including diet and weight loss, are cornerstones of diabetes management.
  • The potential for remission or reversal of diabetes requires further investigation.

Purpose of the Study:

  • To investigate the possibility of reversing or achieving remission in patients diagnosed with diabetes.
  • To re-examine the concept of diabetes as a strictly lifelong diagnosis.
  • To assess glucose tolerance and glycemic control in diabetic patients who have undergone significant weight loss through dietary changes.

Main Methods:

  • Oral glucose tolerance tests (OGTT) were administered twice to 37 patients with a history of diabetes.

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  • Patients had normal glycosylated hemoglobin (HbA1c) levels and a mean diabetes duration of 4.6 years.
  • Weight loss, dietary intake, and HbA1c levels were recorded and analyzed in relation to OGTT results.

    • Main Results:

    • Normal glucose tolerance was observed in 27% of patients, and impaired glucose tolerance in 21%.
    • Glycosylated hemoglobin (HbA1c) levels were significantly lower in patients with normal glucose tolerance compared to those with impaired glucose tolerance (P < 0.05).
    • The response to OGTT varied with dietary intake and weight, indicating reversibility in some individuals.

    Conclusions:

    • A subset of patients with previously diagnosed diabetes can achieve normal glucose tolerance through sustained lifestyle modifications.
    • The findings challenge the notion of diabetes as an irreversible, lifelong diagnosis for all individuals.
    • A review of the definition of diabetes is recommended to accommodate remission in patients who establish permanent healthy dietary habits.