Can Diabetes be Cured Permanently?

Diabetes mellitus, more commonly known as diabetes, is a chronic medical condition that has affected more than 8.9% of total population of India. In this, the level of glucose (sugar) in the blood is significantly increased. There are several different types of diabetes, and they have different causes. But with all types, your glucose can get too high. Most common question that an individual asks when diagnosed with Diabetes is Can Diabetes Be Cured Permanently ?

When you eat, your body breaks most of your food down into glucose. The glucose is then sent into your bloodstream to fuel the cells in your body with energy, including your brain. This triggers your pancreas to release a hormone called insulin, which helps the glucose enter your cells.

If you have diabetes, your pancreas either doesn’t make enough (or any) insulin, or your body’s cells don’t use the insulin the way they’re supposed to. This leads to high levels of glucose in your blood, which causes symptoms.

The disease is incurable, but it can be controlled with medication. Uncontrolled or poorly controlled diabetes is associated with serious health consequences—complications: damage to tissues and organs, including the heart, kidneys (nephropathy), eyes (retinopathy), ears (hearing loss), and nerves (diabetic neuropathy); limb amputations (diabetic foot), Alzheimer's disease, depression, dental diseases.

However, the question of whether or not diabetes can be cured permanently is a complex one that requires a deeper understanding of the condition itself and also current research and treatment options. In this article, we will explore whether diabetes can be cured permanently, examining the latest research and providing an overview of current treatment options.

Types of Diabetes

Type 1 diabetes is insulin-dependent diabetes mellitus (IDDM). The disease is associated with dysfunction of the pancreas. It is the pancreas that produces insulin. With a significant (more than 90%) destruction of the cells responsible for its production, the amount of insulin in the blood falls, carbohydrate metabolism is disturbed. Glucose, still getting into the blood, cannot be absorbed by the body. At the same time, muscle cells are deficient in glucose. As a result, a person with type 1 diabetes loses weight fairly quickly. Type 1 diabetes is more common in people younger than 30 years of age.

Type 2 diabetes is non-insulin dependent diabetes mellitus (NIDDM). This type of disease is caused by tissue loss of sensitivity to insulin. In type 2 diabetes, the level of insulin in the blood can be anything - normal, low or high. But the cells stop responding to it and the concentration of glucose in the blood rises. As a rule, the disease develops against the background of obesity. Type 2 diabetes most often affects people over the age of 30.

Causes of diabetes

Factors contributing to the onset of type 1 diabetes usually include:

•    Heredity. When diagnosing type 1 diabetes in both parents, the probability of the disease is 30%;
•    Viral infections that cause damage to the pancreas (rubella, mumps, chicken pox, hepatitis, etc.);
•    Autoimmune diseases.
The main factors that increase the risk of developing type 2 diabetes are:
•    Heredity. The influence of this factor in type 2 diabetes is higher than in the case of type 1 diabetes. In the presence of type 2 diabetes in one of the parents, the probability of getting sick is more than 40%;
•    obesity, overweight;
•    Impaired glucose tolerance (this condition is called prediabetes). In prediabetes, elevated blood glucose levels are recorded, while other symptoms of diabetes are absent;
•    Age. With age, the likelihood of developing the disease increases;
•    Cardiovascular diseases.

Symptoms of Diabetes 

The main symptoms of type 1 and type 2 diabetes are the same, but each type of the disease has its own specifics.

The complex of the main symptoms is due to an increased content of glucose in the blood. However, if in type 1 diabetes these symptoms are noticeable immediately, then type 2 diabetes can first proceed for a long time without clearly expressed symptoms.

•    Increased urine output
•    Thirst
•    Increased appetite
•    Weight loss
•    Fatigue
•    Visual impairment
•    Itching of the genitals
•    Furunculosis

Pathogenesis of Diabetes

The pathology is based on the insufficiency of the production of the hormone insulin in the beta cells of the islets of Langerhans of the pancreas. Insulin-dependent tissues include liver, fat and muscle. With a decrease in insulin secretion, they stop taking glucose from the blood. There is a state of hyperglycaemia - a key symptom of diabetes. The blood thickens, the blood flow in the vessels is disturbed, which is manifested by visual impairment, trophic lesions of the limbs.

There’s breakdown of fats and proteins due to lack of insulin which then enter the bloodstream and are then metabolized by the liver into ketones, which become energy sources for insulin-independent tissues, including brain tissue. When the blood sugar concentration exceeds, the secondary pathway for glucose excretion is activated - through the kidneys. Glycosuria and polyuria develop, as a result of which the risk of dehydration of the body and electrolyte deficiency increases. To compensate for the loss of water, the feeling of thirst increases (polydipsia).

Treatment 

The patient with diabetes should be aware or be informed about proper diet and exercise with care of diabetes during illness and medications to control the blood sugar. Patient education allows individuals with diabetes to have greater responsibility for their health and control over diabetes.

Psychosocial Aspects 

Because the individual with diabetes can face challenges that affect many aspects of daily life, psychosocial assessment and treatment are a critical part of providing comprehensive diabetes care. The patient must accept that he or she may develop complications related to diabetes. Even with considerable effort? normoglycaemia can be an elusive goal and solutions to worsening glycaemic control may not be easily identifiable. Emotional stress may provoke a change in behaviour so that individuals no longer adhere to a dietary? exercise, or therapeutic regimen. This can lead to the appearance of either hyper- or hypoglycaemia. Eating disorders like anorexia nervosa, binge eating and bulimia etc. may occur more frequently in individuals with type 1 or type 2 Diabetes mellitus.

Diet and Nutrition 

A diet with a moderately reduced energy value due to easily digestible carbohydrates and animal fats. The protein content corresponds to the physiological norm. Sugar and sweets are excluded. The content of sodium chloride, cholesterol, extractives is moderately limited. The content of lipotropic substances, vitamins, dietary fibres is increased. They recommend eating foods such as cottage cheese, low-fat fish, seafood, vegetables, fruits, whole grain cereals, wholemeal bread. Cooked and baked products are preferred, to a lesser extent - fried and stewed. For sugary foods and drinks, instead of sugar, xylitol or sorbitol is used, which are taken into account in the energy value of the diet. The temperature of the dishes is normal. Alcohol and smoking should be avoided.

Chemical composition and energy value: proteins 90-100 g (55% of animals), fats 75-80 g (30% of vegetable), carbohydrates 300-350 g (mainly polysaccharides); energy value of 9.6-10.5 MJ (2300-2500 kcal); sodium chloride 12 g, free liquid 2 – 2.5 L

Diet: 5-6 times a day with a uniform distribution of carbohydrates.

Excluded products and dishes: products from butter and puff pastry; strong, fatty broths, milk soups with semolina, rice, noodles; fatty meats, smoked meats, most sausages, canned food; oily, salted fish, canned oil, caviar; salted cheeses, sweet curd cheese, cream; rice, semolina and pasta; salted and pickled vegetables; grapes, raisins, bananas, figs, dates, sugar, jam, sweets, ice cream; fatty, spicy and salty sauces and other sweet juices, sugar lemonades; meat and cooking fats.

Exercise

For individuals with type 1 or type 2 DM? exercise is useful for lowering plasma glucose (during and following exercise) and increasing insulin sensitivity. In patients with diabetes, it is recommended that 150 min/week (distributed over at least 3 days) of moderate aerobic physical activity with no gaps longer than 2 days. The exercise regimen should also include resistance training. Despite its benefits, exercise presents challenges for individuals with DM because they lack the normal glucose regulation mechanisms (normally, insulin falls and glucagon rises during exercise). Skeletal muscle is a major site for metabolic fuel consumption in the resting state? and the increased muscle activity during vigorous, aerobic exercise greatly increases fuel requirements. 

Intensive Management  

The treatment plan for type 1, and type 2 may include:

•    sulfonylureas ( tolbutamide, glibenclamide );
•    biguanides, which reduce gluconeogenesis in the liver and increase the sensitivity of muscles and liver to insulin ( metformin );
•    thiazolidinediones (glitazones), similar in properties to biguanides ( pioglitazone , rosiglitazone );
•    alpha-glucosidase inhibitors that reduce the rate of glucose absorption in the gastrointestinal tract ( acarbose );
•    agonists of glucagon-like peptide-1 receptors, stimulating the synthesis and secretion of insulin, reducing glucose production by the liver, appetite and body weight, slowing down the evacuation of the food bolus from the stomach ( exenatide , liraglutide );
•    inhibitors of depeptidyl-peptidase-4, which also stimulate the synthesis and secretion of insulin, reduce the production of glucose by the liver, do not affect the rate of evacuation of food from the stomach and have a neutral effect on body weight (sitagliptin , vildagliptin ) ;

Insulin therapy

Depending on the severity of the disease and the complications that arise, the doctor prescribes insulin. This method of treatment is indicated in approximately 15-20% of cases. Indications for the use of insulin therapy are:
•    Rapid weight loss for no apparent reason;
•    The occurrence of complications;
•    Insufficient effectiveness of other hypoglycaemic drugs.

Combination Therapy With Glucose: Lowering Agents: A number of combinations of therapeutic agents are successful in type 2 DM (metformin + second oral agent? metformin + GLP- 1 receptor agonist? or metformin + insulin) and the dosing of agents in combination is the same as when the agents are used alone.

Blood sugar monitoring: Tracking your glucose with a blood glucose monitor or continuous glucose monitor (CGM) is especially important when you have type 1 diabetes or type 2 diabetes and use insulin. It’s likely that your doctor will want to regularly check your A1C too since this shows your average glucose level for the past two to three months.

Surgery

Despite the many hypoglycemic drugs, the issue of their correct dosage, as well as the adherence of patients to the chosen method of therapy, remains unresolved. This, in turn, creates difficulties in achieving long-term remission of type II diabetes. Therefore, surgical therapy of this disease, bariatric or metabolic surgery, is gaining more and more popularity in the world. The MFD considers this method of treatment for patients with type II diabetes to be effective. Currently, more than 500,000 bariatric surgeries are performed worldwide every year. There are several types of metabolic surgery, the most common being gastric bypass and mini gastric bypass.

When Lifestyle Changes and Medication Aren’t Enough!!

Sometimes even medications and lifestyle changes can’t fully manage diabetes. When this happens, there are other treatment options, including:

•    Bariatric surgery: This may be an option for you if you have type 2 diabetes and a body mass index, or BMI, over 35 (class II obesity or higher). Because this surgery helps you lose weight, it can also significantly improve your glucose levels.

•    Transplantation: A pancreas transplant may help certain people with type 1 diabetes. Organ transplants carry many risks, so these need to be weighed along with the benefits. Another type of transplant that’s being researched is a pancreatic islet transplant. This involves transplanting the groups of cells that make insulin, called islets, from a donor pancreas into yours.

•    Immunotherapy: This is also being studied as a possibility for treating type 1 diabetes.

Treatment for Prediabetes

If you have prediabetes, the focus is to prevent you from developing type 2 diabetes. The main treatment for prediabetes is lifestyle changes such as exercising regularly, losing weight, and following a healthy eating pattern. These can get your glucose back to normal, or at least delay it from getting into type 2 levels.

Can Diabetes Be Cured Permanently?

“Unfortunately, diabetes doesn’t have a permanent cure.”

1.Type 1 Diabetes

A type 1 patient might experience some improvement in their insulin demand, as sometimes the need for insulin will seem go away, as the blood glucose level stays at a normal rate. This is basically a deceptive stage, whereby a type 1 diabetes patient is without any symptom of diabetes for some months to even a year! Do not be deceived into thinking that you are totally free from diabetes, as in patients with type 1 diabetes, about 90% of the insulin-producing cells are defunct. Eventually, the remaining 10% of these cells will be destroyed and the patient will finally be 100 % dependent on insulin injections. So it is advisable to continue taking insulin shots during the “honeymoon period” in order to preserve the few remaining cells capable of insulin production as long as possible.

2. Type 2 Diabetes

Can type 2 diabetes be cured permanently? Well, type 2 diabetes, like type 1, has no cure and could also be very misleading at times. For example, when an overweight type 2 patient begins to engage in exercise and workouts, they will lose weight and attain a stable blood glucose level. This eventually brings to mind the idea that diabetes has magically rolled away. Do not let your body trick you into believing that, as type 2 diabetes occurs in stages. For people with type 2 diabetes, the body will either produce less insulin or the body cells will be resistant to insulin. The patient will first be glucose tolerant impaired and then have full-blown diabetes. Type 2 patients are always on alert, as any slight change in their physical activity and weight will result in a double-fold amount of blood glucose, making it impossible to curtail the glucose level with just physical exercise alone. The use of oral medication or injection to maintain a proper and healthy blood glucose level will become inevitable.

Lifestyle Changes for Diabetes

Lifestyle changes can keep your glucose within range, lower your risk of complications, and help you stay healthy and live a long life. No matter what type of diabetes you have, experts encourage making lifestyle changes such as:

•    Planning meals
•    Exercising for 30 minutes at least five days a week
•    Losing weight if you’re overweight
•    Getting enough sleep
•    Eating a healthy diet
•    Quitting if you smoke
•    Lowering your stress
•    Limiting alcohol
•    Managing your blood pressure and cholesterol to help prevent heart disease, a potential complication from diabetes
•    Taking all your medications as prescribed
•    Keeping all your doctor and lab test appointments

For help individualizing the above changes, consider seeing a certified diabetes care and education specialist (CDCES), a certified diabetes educator (CDE), or a registered dietician nutritionist (RDN).

Conclusion

Unfortunately, there is no cure for diabetes. However, there are ways to improve the quality of life of patients with this disease. 

Till date, there are a large number of “bases” where endocrinologists explain to patients what their lifestyle should be like, how to eat right, what foods should not be consumed, what should be daily physical activity.

A huge number of hypoglycaemic drugs have also been created, which are improved every year. In order for them to have a positive effect on the body, medicines must be taken regularly.

Practice shows that compliance with all the recommendations of endocrinologists improves the treatment of diabetes.

Bariatric surgery is an operative method that improves the quality of life in type II diabetes, according to the MFD.Significantly improve the condition of patients with this disease allows gastrointestinal operations (morbid obesity therapy), as a result of which the level of glycohemoglobin and glucose in the blood normalizes, the need for the use of antidiabetic drugs and insulin is lost.

Bariatric surgery can lead to significant and sustained remission as well as improvement in type II diabetes and other metabolic risk factors in obese patients. Surgery within 5 years of diagnosis most often results in long-term remission.

To prevent the occurrence of type 1 and Type 2 diabetes, the following preventive measures must be observed:

•    Diet - if you are overweight, you need to monitor what is included in the diet: it is very useful to eat vegetables and fruits with a low glucose content, while limiting the use of foods such as bread, flour products, and potatoes, fatty, spicy, smoked and sweet dishes.

•    Doable physical activity - there is no need for exhausting workouts. The best option would be daily walking or swimming in the pool. Light exercise, if done at least five times a week, reduces the risk of diabetes by 50%.

•    Normalization of the psycho-emotional state is an integral method of preventing this disease. It is important to remember that stress can cause metabolic disorders leading to obesity and the development of diabetes. Therefore, it is necessary to strengthen stress tolerance.

Compiled by Dr. Rakesh Kumavat MBBS - Team ProceedFit

Disclaimer : The information provided in this article is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. If you have any concerns about your health or are experiencing symptoms, it is important to consult with a healthcare professional. They will be able to assess your specific situation and provide you with personalised advice and treatment based on your symptoms, body type, allergies (if any), existing medical conditions etc. It is always a good idea to consult with a healthcare professional before making any decisions about your health.