Can you reverse type 2 diabetes?
The 5 myths of diabetes reversal
Can you reverse type 2 diabetes?
Healthcare executives and professionals — and certainly people living with diabetes — have all asked themselves this question. The appeal makes sense. A potential cure would have an incredible impact on both people’s lives and healthcare spending.
Nonetheless, diabetes reversal remains biologically impossible.
Type 2 diabetes, a health threat affecting 11% of American adults, can be prevented. It can also be successfully managed to improve overall life quality and outcomes. However, once the body’s physiology is altered, the effects of type 2 diabetes cannot be reversed.
So then why do we think reversal is possible?
This attractive idea is fueled by solutions on the market hoping to carve out their niche in diabetes treatment. Reversal would be a miracle; but it’s a sale’s pitch, not reality.
Leading endocrinologists and experts have set the record straight. They clarified that “returning to glucose levels below those diagnostic of diabetes” qualifies as diabetes remission — not diabetes reversal.
Diabetes is a growing problem in this country and threatens the health of millions of Americans. In the United States, 38% of the adult population has prediabetes. What’s more, 1.4 million Americans are diagnosed with diabetes every year.
This sobering trend has health plans, providers, and technology solutions all hungry for a simple solution. And while reversing diabetes would certainly be beneficial, it simply remains physiologically unattainable.
In fact, diabetes care goes beyond trying to “reverse” A1C levels and beta cell function. Proper management and remission plans take additional comorbidities and mental health complexities into account. These complexities often require nearly equal attention when creating treatment plans.
Those who live with diabetes are 2 to 3 times more likely to also face mental health challenges like depression.
With over 37 million Americans diagnosed, healthcare leaders cannot accept overly simplified or misleading approaches to solve this mounting challenge. Understanding the myths that surround diabetes care is the first step in combating the pain, cost, and complications associated with the diabetes epidemic in America.
Myth #1: You can reverse diabetes
Some solutions and techniques will result in prompt, impressive results. For example, following a highly restrictive diet can produce winning results in the short term. However, it cannot erase years of damage to beta-cell function.
Once someone has type 2 diabetes, they’re now permanently more likely to develop high blood sugar and other symptoms of diabetes; this is why diabetes is considered a chronic condition.
Diabetes reversal is an inaccurate representation of diabetes care, but that doesn’t mean remission isn’t a worthy goal.
The American Diabetes Association (ADA) defines remission as a return to A1C levels lower than 6.5 sustained for at least 3 months without the use of diabetes medication.
However, even those who achieve remission shouldn’t assume their journey has ended. It’s recommended they still get tested at least yearly to ensure they remain below the 6.5 A1C level. Additionally, they should undergo routine testing for common complications of diabetes.
These measures can improve quality of life in the near term and help prevent costly interventions down the road.
Myth #2: Diet alone can count as diabetes care
There’s no doubt that formulating a healthy eating plan plays an important role in diabetes care.
But some diabetes solutions make an extreme diet the focus of their entire program. Solutions that market diet alone in support of diabetes reversal don’t tell the whole story.
Restrictive diets can indeed work for a subset of highly motivated individuals. But these people are the exception, not the rule. It’s not a viable solution for the majority of those who have diabetes.
Studies show that restrictive diets of any kind tend to not produce successful results for longer than 12 months.
Many people with diabetes may need some medication to start, and all will benefit from care plans that address their physical and mental health.
In addition to diet, regular exercise plays an essential role in treating type 2 diabetes. Immediately after exercise, people with diabetes see substantial metabolic benefits; they continue to see even greater benefits after months and years of exercise training. By working with clinicians for an optimized diet, medication, and work-out plan, individuals can experience the full benefits of their efforts.
Myth #3: Diabetes is just a physical health condition
Studies show that diabetes and depression are closely linked.
Diabetes distress (feeling overwhelmed by what’s required to manage the disease) can cause depression. But other common biological and lifestyle factors can contribute to both diseases as well. These include obesity, inflammation, sleep disturbance, and inactivity.
Less than half of people with diabetes and depression receive the dual diagnoses, even though they’d greatly benefit from therapy, antidepressants, or both.
Many doctors recommend treating diabetes and depression together for help in improving long-term results and saving costs.
While diabetes reversal still remains an impossibility, diabetes management requires a patient-centered care team approach, integrating physical and mental health together.
Rather than just relying on remote monitoring, members need video-based counseling with health coaches, diabetes educators, registered dietitians, and therapists to successfully combat both diabetes and depression.
Myth #4: Everyone can improve their diabetes through the same formula
People are incredibly complex. They come from different places, families, cultural traditions, socioeconomic statuses, and genetics.
When it comes to a person’s medical journey, care plans and costs will differ based on individual needs. A one-size-fits-all formula can be difficult to achieve for many people — particularly when that formula’s success depends upon following a prescribed eating plan, exercise regiment, and access to smart devices.
Solutions supporting diabetes reversal through a very focused approach, like prioritizing diet changes, miss key components that are key to long-term health success and cost savings.
Adapting treatment plans to individual needs will yield greater results overall. For example, the ketogenic diet may purport to be ideal for people with diabetes, but it simply doesn’t work for everyone.
In addition, many of the recommended foods for a ketogenic diet aren’t accessible or affordable to most Americans. Research shows that diabetes disproportionately affects low-income populations, as well as racial and ethnic minority groups. Moreover, the keto diet doesn’t work for all cultural food traditions.
Health plans are continually aiming for more cultural sensitivity in their outreach.
In order to serve their diverse populations, health plans need to offer solutions that help their people adhere to nutritional guidelines that work within their family and cultural structure.
Myth #5: Total remission should be the goal
While diabetes reversal itself isn’t possible, remission is a realistic goal for most people living with diabetes.
But should total remission be the goal of all diabetes care?
Often multiple conditions make diabetes management infinitely more complex than just reaching a pie-in-the-sky benchmark. Depression, hypertension, obesity, and other common comorbidities may alter plausible goals for an individual. Patients with high acuity conditions need providers who can individualize A1C goals that appropriately match each patient’s unique situation.
And the number of high acuity patients is growing — nearly half of all individuals with type 2 diabetes are at least 65 years old.
In order to treat a population with various levels of acuity, you need a flexible solution that focuses on fostering trusting relationships between patients and caregivers.
Only well-informed patients and their equally invested care team can define total remission as the appropriate goal.
How Vida Health personalizes care goals for people with diabetes
People with diabetes deserve personalized, human-centered care that emphasizes an integrated approach for whole health.
Ninety-five percent of our members report feeling a strong connection with their care team. For those who don’t make a strong connection, they’re given the option to change their providers to best fit their needs. We emphasize trust in our human providers and offer an easy-to-use, seamless experience in our app.
Members achieve a 33% greater reduction in A1C when we treat them for diabetes and depression simultaneously with Vida’s whole health approach.
If you want to offer a solution for a diverse population of members with co-occurring conditions, consider Vida’s whole health solution that offers integrated physical and mental healthcare all in one platform. You’ll be able to reach the largest number of members and offer them a sustainable solution with wrap-around care.