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After seeing the patient, the doctor told the family that the black "dirty stuff" on the child's neck was more consistent with a common sign in the endocrinology department - acanthosis nigricans. Combined with the current symptoms and signs, insulin resistance,High blood sugarIt is very likely. Hearing this, the mother added anxiously: "The child's father hasdiabetes, and has been taking medicine for treatment. "When she heard that her child might have diabetes, the mother was extremely worried and anxious. So the doctor further conducted a detailed laboratory test on the child, and the results showed that the fasting blood sugar was 13.8 mmol/L, the glycosylated hemoglobin was 10.9%, and the blood lipids,Uric acidSignificantly elevated, normal pancreatic function, diabetes relatedAntibodyNegative. ConsideredType 2 diabetes, combined with hyperlipidemia, hyperuricemia,obesityDiseases such as metabolic syndrome are typical diseases.

After 6 months of treatment, the patient's weight dropped from 94 kg to 80 kg.metabolismAll indicators returned to normal, and the black skin on the neck disappeared. So all hypoglycemic drugs were stopped, and the patient only controlled his diet and exercised.blood sugarLevels are still completely normal. Was the patient's diabetes reversed?

Through this case, you may think that reversing diabetes is very simple. Can all diabetes be reversed? The answer is no. Only those people with type 2 diabetes who are obese or overweight can achieve reversal. In our clinical observation, we found that the factors that affect the reversal of diabetes are mainly the following:

◎ ComplianceCompliance refers to whether the patient can strictly follow the doctor's instructions during the treatment process. The more strictly the patient follows the doctor's treatment plan, the greater the possibility of diabetes remission; on the contrary, for those who cannot strictly follow the doctor's instructions, the probability of achieving remission is relatively small.

◎Disease courseThe shorter the course of diabetes, the greater the probability of achieving reversal. We have observed that for patients with newly diagnosed type 2 diabetes and obesity, the probability of diabetes remission can reach more than 70% through reasonable and standardized treatment; the probability of diabetes remission decreases by about 10% for every additional year of diabetes course; for people with diabetes course of more than 5 years, the probability of diabetes remission drops sharply to less than 10%. This shows the importance of course of disease for diabetes remission.

AgeThe function of pancreatic beta cells declines with age, so the older you are, the worse your pancreatic function is, and the less likely you are to reverse diabetes. We found that among patients who have reversed diabetes, those aged 18 to 30 accounted for more than 50%, those aged 30 to 35 accounted for about 30%, and those aged 35 to 45 accounted for about 10%. For those aged >45, even those with newly diagnosed diabetes, the possibility of reversal is very small.

◎Basic weightBasic body weight is closely related to whether diabetes can be reversed, because the larger the basic body weight, the greater the room for weight loss. We found that when diagnosed with diabetes, patients with a body mass index (BMI) of 25-28 had a probability of diabetes remission of about 30%; patients with a BMI of 28-30 had a probability of diabetes remission of about 50%; and patients with a BMI>30 had a probability of diabetes remission of about 60%.

◎Amount of weight lossThe better the weight loss effect, the greater the probability of diabetes remission. According to literature, if the weight loss is 0-5 kg, the diabetes remission rate is about 7%; if the weight loss is 5-10 kg, the diabetes remission rate is about 34%; if the weight loss is 10-15 kg, the diabetes remission rate is 57%; if the weight loss is greater than 15 kg, the diabetes remission rate is 86%.

Treatment processThe more standardized the treatment, the more likely it is to reverse diabetes. For example, in the case at the beginning of the article, after the patient was diagnosed with diabetes, he first usedinsulinAfter one month of treatment, insulin was discontinued and hypoglycemic drugs were continued, eventually achieving diabetes reversal. In our observations, we found that newly diagnosed patients with type 2 diabetes and obesity, through 2 to 4 weeks of intensive insulin treatment (including insulin pumps, subcutaneous insulin injections, etc.), discontinued insulin, and continued hypoglycemic and weight loss treatment, the probability of diabetes reversal can even reach more than 80%. In the case of irregular treatment, especially after the onset of the disease, the probability of diabetes reversal will be greatly reduced in patients who are afraid of insulin and refuse insulin.

◎Misconception 1: The stricter the diet, the better

The stricter the diet is, the better it is. Some diabetic patients control their diet excessively and deliberately reduce carbohydrates,proteinSome people even adopt extreme diets such as zero-carb and no-carb, which often lead to insufficient calorie intake, unbalanced nutrition, starvation ketosis, malnutrition, etc. Although blood sugar is well controlled, it brings other complications, which is not worth the loss. Moreover, long-term strict dietary control and insufficient calorie intake will cause the body to provide energy by breaking down protein, which will increase the risk of muscle loss. Therefore, you must have a balanced diet and don't go to extremes.

◎Myth 2: The faster you lose weight, the better

Some people, in order to achieve diabetes reversal, blindly pursue the speed of weight loss, which leads to increased muscle loss in the later stage, often causing fatigue, decreased endurance, fatigue, and even depression, sexual dysfunction and other combined symptoms. In the process of diabetes reversal, the weight loss in the first 3 months should not exceed 10% of the basic body weight, and the weight loss in 6 months should not exceed 20% of the basic body weight; at the same time, in the process of weight control, it is necessary to appropriately increase protein intake, pay attention to strength training (especially aerobic exercise and resistance exercise), ensure rest and sleep, and reduce muscle loss.

◎Myth 3: The lower the blood sugar, the better

Most diabetic patients tend to excessively pursue blood sugar control results after the initial diagnosis of diabetes. They frequently measure fingertip blood sugar or even wear dynamic blood sugar monitors to monitor blood sugar. Once blood sugar rises, they will show anxiety. Excessively strict blood sugar control will increase the risk of hypoglycemia and even cause ischemia and hypoxia of target organs, causing dizziness, weakness, fatigue, memory loss, poor sleep, etc. Therefore, do not blindly pursue blood sugar control results. Gradual progress is the best choice.

In short, it is not easy to reverse diabetes. It requires great efforts in the reversal process and you need to be careful to avoid misunderstandings. Only in this way can you achieve reversal of diabetes.