2009/06/12

remission? cure? control?

2003/12/16 "Looks to me like you're not diabetic anymore."
—my Kaiser Permanente doctor

Wow. I didn't think they were allowed to say that. Nor that any doctor would ever say, as mine did later in the same conversation, "You've cured yourself."

As I've learned since, only the first of these statements is true. Being "not diabetic anymore" can serve, with certain caveats, as an attainable goal in diabetes control. This is what I, along with more and more lay people and professionals, call remission.
The technical term is normoglycemia: normal, or non-diabetic, levels of blood glucose (blood sugar).

I was diagnosed as a type 2 diabetic in December of 2002, after at least three frustrating years of debilitating, bloody, scary symptoms. In January, 2003, I started an aggressive, measured program of self-treatment through diet and exercise. My health improved dramatically. Over the course of a year, I lost about a hundred pounds. Since June of that year, my blood sugar readings were consistently good enough that I began to have vague hopes that I might someday hear the word "remission"—so vague that as I made up my list of things to take up with the doctor a year after my diagnosis, that question literally didn't even enter my mind.

Suddenly I was hearing "cured yourself" and "not diabetic anymore". Sweet Jesus!

2009/01/14 "[Y]ou are not diabetic, but you aren't cured of diabetes either. It could be said that you have diabetes but you're not diabetic—but that sounds too ridiculous."
—Tom Ross, of Not Medicated Yet

After years of backsliding and recurring symptoms, I've learned that the question of cure, remission, and control is more complicated than I or my doctor had thought. As Tom Ross points out, a person can have diabetes and be "not diabetic". In the same dLife.com forum discussion, "nomorecarbs" writes:
I've had blood sugars in excess of 400, today they are usually in the seventies or eighties. If I ate a loaf of bread, I'd wind up closer to 200 than 100. Am I cured? As far as I'm concerned, it's just semantics, as long as I maintain normal blood sugars, I believe I'll avoid complications. I've been diabetic for 30 years, did develop complications, they've been reversed. There are people who've been diabetic for over 50 years, and they're complications free. There are people in their 60s who are not yet diabetic, but will be and who will develop complications. It's all in how you manage your life after diagnosis. As far as I'm concerned, it's just a word, "cure". If you mean can you live a normal life expectancy with no complications, yes, diabetes can be cured. If you mean, can you eat whatever you want, stop being physically active, and still remain healthy, no, diabetes is not "curable".

The feeds and links on this page, along with some additional information on diet and exercise, are the chief online resources I used to put myself into remission, or use to this day in the hope of returning to that state.

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