Can Diabetes be Cured?

Can diabetes be cured?

In general, we do not consider that diabetes can be cured once it has been diagnosed. People with type 2 diabetes can reverse  the detectable abnormalities of diabetes by lifestyle  adjustment without  the  use of medications  (discussed in  Question  28).  However, the tendency to manifest high blood  sugar again is always  present  if  the  patient  is  under  significant metabolic stress, such as that caused by medications, severe illness, injury, regaining lost weight, cessation of exercise, aging, etc. Therefore we consider that dia- betes can be  under excellent control or in remission, but we do not usually use the word cured. Even peo- ple with type 1 diabetes who have undergone success- ful  pancreas or  islet transplantation  and  no  longer require insulin therapy cannot be considered  cured. There  is a significant possibility that  their diabetes will  one  day  come  back  for  a  variety of  reasons, including  rejection of  the  transplant  or  a  renewed attack on the transplanted islet tissue by the patient’s immune system.

Perhaps the closest we have been able to come in the search  for  a true cure for diabetes is the  effect of bariatric surger y  (“weight  loss  surgery”),  which either  involves  procedures  to  restrict  the  entry  of food into the stomach or  procedures to bypass the stomach  and  upper  intestine,  thus  reducing  food absorption.  Procedures  of  the   bypass  type   have shown  prolonged  remission  of  diabetes  in  up  to

80% of cases for as long as 10 years. Remission for

10 years or more is approaching a definition of a true cure, and in the future this and other medications or procedures that provide a long-term reversal of obe- sity may come to be  generally accepted as “curing” type 2 diabetes.