Diabetes? Some beat it, but are they cured?

Apr 19, 2009 By JAMIE STENGLE , Associated Press Writer
This April 16, 2009 photo shows JoAnne Zoller Wagner, 55, walking near her home in Pasadena, Md. Wagner, who was diagnosed with type 2 diabetes, exercises regularly to keep her blood sugar levels at a healthy, normal range. (AP Photo/Patrick Smith)

(AP) -- JoAnne Zoller Wagner's diagnosis as prediabetic wasn't enough to compel her to change her habits and lose 30 pounds. Not even with the knowledge her sister had died because of diabetes.

"I didn't have that sense of urgency," said the Pasadena, Md., woman.

But nine months later, doctors told Wagner her condition had worsened. She, too, now had Type 2 .

That scared her into action.

Now, two years later, the 55-year-old woman has slimmed down. She exercises regularly and her levels are back in the healthy, normal range. Thanks to her success, she was able to avoid diabetes medication.

Diabetics like Wagner who manage to turn things around, getting their blood sugar under control - either escaping the need for drugs or improving enough to quit taking them - are drawing keen interest from the medical community.

This summer an American Diabetes Association task force will focus on this group of patients and whether they can be considered "cured." Among the points of interest:

-What blood sugar range qualifies as a cure and how long would it have to be maintained?

-How might blood pressure and cholesterol, both linked to diabetes, figure into the equation?

-And what if a "cured" diabetic's blood sugar soars again?

"For right now, we're not saying they're cured, but the bottom line is ... good glucose control, less infections," said Sue McLaughlin, president of health care and education for the American Diabetes Association. The organization has no estimate of how many people fall into that category.

Being overweight is the leading risk for . Genetics also plays a role, and blacks, Hispanics and American Indians are at greater risk than whites.

Nearly 57 million Americans are prediabetic. Another 18 million have been diagnosed with diabetes, while the diabetes association estimates almost 6 million more Americans have diabetes and don't know it. About 90 to 95 percent of diabetics have Type 2, the kind linked to obesity.

The future is potentially even gloomier, with one study estimating that one of every three children born in the U.S. in 2000 will eventually develop diabetes.

But the news isn't all bad. Thirty minutes of daily exercise and a 5 to 10 percent loss in body weight can lower the odds of diabetes by nearly 60 percent and is more effective than medicine in delaying its onset, according to a diabetes prevention study.

Still, such lifestyle changes are often difficult.

"It sounds like such a nonmedical recommendation, and yet it's the thing people say is the toughest to implement," said McLaughlin, the diabetes association official.

For Wagner, it meant changing not just her diet, but her lifestyle. A teacher, she now cooks most of her meals at home and avoids the sweets in the school lounge. She also tries not to stay late at work, using the extra time to exercise and make healthy meals.

Alice Stern describes a similar journey back to health since her diabetes diagnosis in 2007. The 50-year-old Boston woman was able to avoid diabetes drugs through diet and exercise, managing to trim 40 pounds off her 5-foot-2 frame.

"It is about willpower. That's how you make the changes," said Stern.

Even diabetics who have resorted to surgery have seen their return to normal.

Lucy Cain, 61, of Dallas tried to control her diabetes through diet and exercise after she was diagnosed in 2004. But she found it difficult, and two years later had gastric bypass surgery. The 5-foot-7 Cain, who once weighed over 300 pounds, is down to about 185, still losing weight and is off diabetes medication.

Whatever the route, weight loss is key, doctors say.

"There is no special diet. You've got to eat fewer calories than your body burns," said Dr. Robert Rizza, a Mayo Clinic endocrinologist and former president of the American Diabetes Association.

Many doctors stop short of calling these successful patients cured.

Dr. Philipp Scherer, director of the diabetes research center at University of Texas Southwestern, describes diabetes as a one-way road. He said it can be stopped in its tracks with diet and exercise, but there's no turning back.

Dr. Kevin Niswender, an assistant professor in the department of medicine at Vanderbilt Medical Center, said "technically, you could call somebody cured," but that patient still needs to be followed closely.

Doctors caution that, for some diabetics, lowering blood sugar may be only temporary. Stress, weight gain and other factors can push it back to unhealthy levels.

"Blood sugars can come down to normal. Then the issue is how long does that last?" said Dr. Sue Kirkman, vice president of clinical affairs for the diabetes association. "Sometimes people start putting weight back on and their blood sugars come back up."

In other cases, patients are diagnosed so late that blood sugar levels can't be brought back to normal, even with weight loss, she said. As the disease progresses, even those who made diet and lifestyle changes might eventually have to go on medications.

That's one reason Wagner and some other diabetics who've managed their disease through diet and exercise are also reluctant to consider themselves "cured."

"American culture, our environment, is not conducive to having good health," said Wagner. She believes diabetes will always be lurking in the background, waiting for her to slip.

---

On the Net:

American Diabetes Association: http://www..org/

©2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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jimmie
not rated yet Apr 19, 2009
My Doctor called it 'remission' and that
seems to be the best terminology.
( H1AC 6.4 )
TomaG
not rated yet Apr 25, 2009
This is a question that has had my attention for a while. Based on feedback from other type 2 diabetics who have controlled and even reversed type 2 diabetes symptoms I am wondering if the doctors are just behind the curve of current nutrition and type 2 diabetes research. You give examples of others who are also maintaining normal glucose and glycated hemoglobin levels without medications. (I am sure the drug companies don%u2019t want the word to get out that this can be done.)



I am one more you can add to your list that has totally reversed type 2 diabetes and maintains very good blood glucose levels and A1C. I would love to find out how to become part of the study group you mentioned. My mother is another one. 3 years ago her toes were purple from neuropathy. Now her toes are pink and healthy. There are many other members of my website that are telling me their success stories too.



After 4 years of researching first for my own needs then for the website I am coming to question may of the things mainstream medicine believes to be true.


1. "Being overweight is the leading risk for Type 2 diabetes".

Is that really true? I know and have seen overweight people regain really good glucose control without losing the weight. There are many type 2 diabetics who are not overweight. I have seen it is not just calorie restriction (which I consider a good thing for most people) but also the type of calories consumed.


2. Quoting Dr. Robert Rizza, a Mayo Clinic endocrinologist, "There is no special diet. You've got to eat fewer calories than your body burns."


I strongly disagree. In fact, I would say it is all about diet and getting it right. We as non-professionals and type 2 diabetics have proven to ourselves and other willing to try what we are doing that an optimized, low glycemic, anti-inflammatory diet turns things around not only for type 2 diabetes but also for a number of other inflammatory diseases.

3. "Blood sugars can come down to normal. Then the issue is how long does that last?" said Dr. Sue Kirkman, vice president of clinical affairs for the diabetes association.

The diabetes Association is closely linked to the drug companies and the ADA's standard and practices guidelines strongly endorse the use of drugs as the way to control it. There has to be acknowledgment that we got into trouble from a very bad diet. If we adopt an optimized diet we see positive results. If we go back to a bad diet through social pressures or for whatever reason we will see the diabetes return. There is a lot of social pressure to be like everyone else and partake of the same horrible foods served at most social functions.

4. "American culture, our environment, is not conducive to having good health," said Wagner. She believes diabetes will always be lurking in the background, waiting for her to slip.

I totally agree, look around next time you are out. Fast food joins, ice cream stands, candy, donut shops, soda machines and heavily sugared drinks everywhere. Almost impossible to find any healthy choices. Even at home we are bombarded with food commercials and I cannot remember the last time I saw a commercial or cooking show with or for healthy foods.

When I was diagnosed in February 2005 the ADA recommendations supplied to me by the Veterans health system were flat not working. I searched the internet for a good diabetic site that could tell me how to do an optimized diabetic diet. There wasn%u2019t one and the worst sites were the official medical and government sites. I did find better answers by searching out bits and pieces of the puzzle from hundreds of different sites. Since there was not a site I took what I had learned to control my own diabetes and built a site to help others. I have a lot of anecdotal information that says what we are doing works. I am trying to get a diabetic diet study site launched to validate it in a way that can be presented to the scientific community.



Toma Grubb

A1C 5.0 -5.6 for past 4 years without meds.

http://www.Diabet...rets.com

Bethie
not rated yet Apr 25, 2009
I would love to find out how to become a part of the study group as well. My A1C is 5.6 I was diagnosed early, put on metformin for 3 months, and in 3 months time, I lost 28 lbs. I've been doing great being off the medication, still sticking to a good diet and exercise daily. My cholesterol and blood pressure are good. This article gives me some hope because I've practically been told, I will have some sort of problem realted to diabetes in the future, and eventually will need to go back on medicine, and the odds are, I have been told by professionals, are greater that I will be on insulin. I don't want to believe that. I think there are exceptions.

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