Diabetes is on a rapid rise in India and has already affected 30 per cent of the population. As per a Lancet study, almost 101 million people in India, around 11.4% of the country's population, have diabetes, while 136 million people, around 15.3% of the people have pre-diabetes. Amid the growing threat of this lifestyle disease for which Indians have more propensity compared to most of the other countries, the question of the disease's reversal has become more pertinent.
The increase in cases of diabetes is making people dependent on medicine, including insulin. While remission is possible in some cases, particularly newly diagnosed obese patients, it may not be possible in many others. People in remission can remain without medicines but will have to get themselves screened periodically as remission doesn't mean cure. There is increasing evidence to show that people in India can live long without complications of diabetes if they exercise and follow good diet and drug regimen.
Times Internet is launching TOI Health+ with a thought provoking webinar by senior diabetologist Dr V Mohan, chairman of Madras Diabetes Research Foundation answers whether or not, reversal of diabetes is possible in all individuals.
Threat of diabetes growing; need for prevention
Dr V Mohan says not everyone will get diabetes, but some cities are witnessing a greater increase in the disease compared to others.
"We are seeing it in some cities like Chennai, Delhi and so on. It has already reached 30% of the population. In many states like UP and Bihar, prediabetes is very high and diabetes is low, which means they are going to convert (to diabetes later in their life). In some Southern states, prediabetes is already beginning to go down and diabetes rates are going very high," says the expert.
He stresses upon the importance of preventing the disease in states where there is still scope to curb the diabetes threat and more people are in the bracket of prediabetes.
Is remission of diabetes possible?
Diabetes remission happens when the blood glucose levels of a person living with type 2 diabetes stay below the diabetes threshold without medicine.
But is it for everyone or for that matter for every kind of diabetes? Dr V Mohan says in some types of diabetes like type 1 diabetes and fibrocalculous pancreatic diabetes, remission isn't a possibility, but many cases of type 2 diabetes can be reversed provided the person meets certain criteria and is willing to introduce appropriate lifestyle changes.
"In case of type 2 diabetes (in the prediabetes stage or even later), there is a long natural history and you can intervene before you get diabetes. After you get diabetes, there are many years before diabetes complications begin. So, we can talk about remission of diabetes," says Dr V Mohan.
Here're 5 factors that Dr V Mohan says are considered when it comes to deciding whether or not a person can go into diabetes remission. He calls it ABCD mantra.
1. A - A1C
A stands for A1c, which means the degree of control of diabetes. A normal value of 5.6, up to 6, 6.4 is considered for remission. If it's 8, 9, it's diabetes, but still holds a chance.
2. B- Body weight
B stands for body weight. Higher the body weight, the more there are chances of achieving remission. A thin person with type 2 diabetes will more likely have severe diabetes with no insulin in the body. They are not going to get into remission by adding or cutting something in the diet. The more obese you are, more there are chances of going into remission.
3. C- C peptide
It is a good index of insulin secretion. The more C peptide you have, the greater your chances of reversing your diabetes, but if it is low, (this means) already the pancreas is gone.
4. D - Duration of the disease: The longer the duration, the more difficult it is to achieve remission.
5. E - An enthusiastic individual: If you are not enthusiastic, you are not going to achieve remission. It's not about a few months, but you need to go on a diet lifelong.
