Understanding diabetes.

[don9999]

I have a question which I want to ask with the help of a hypothetical example. I asked this question to couple of my doctor friends, but can't get reply.

There are 2 person in their 40s, say A & B. Both are overweight and same BS levels, though they have not checked it. (assumption)

Now, Mr. A decide to check his BS and found that its just crossed diabetes levels. He decide to control with diet and exercise. On the other hand Mr B is just worried about his weight and changes his diet and start exercise. After say 6 months, both lost good amount of weight. Then, Mr A recheck his blood sugar and found that they are in normal range. So, he is declared as a 'Diabetic with good Control' (because modern medical science believe that diabetes can't be cured) whereas Mr B check his blood sugar for first time, its in normal range and he is declared as Non-Diabetic.

Is this correct understanding?

[rvmasalvad Volunteer Star]

no.once a diabetic always a diabetic.He can control blood sugar by methods described by you.

[sandybrown]

I am afraid each human is very different!, human body react to different things in so many ways. Even a fully qualified doctor may not be able to answer your question.

According to many new studies one can reserve diabetic, this is a way of controlling blood glucose by food and drink intake control and regular exercise.

I am not sure if A and B in real life exists. In UK there was a TV program, this fat Indian, The fat is in the body of the thin person due to food and drinks intake. In UK people are over weight and type 2.

[Praveen55 Moderator]

don9999

It is good that you asked this question. Any Doctor can answer this question but they choose not to answer because they generally like to give instructions to patients not explanations.

1. Consider Mr A case who has been declared diabetic. You have to understand that declaring someone full-blown diabetic is not as simple as you put it '' just crossed diabetes levels''. There are stringent test protocols before confirming someone has diabetes.Tests are done more than once to avoid possibility of error. And there are various stages of this metabolic disorder e.g. insulin resistance, pre-diabetes, diabetes.

The way you have described the condition of Mr A, I assume his diagnosis is early stage type 2 diabetes which means his blood test results may be following:

Fasting BG: More than 130 mg/dl

2 hour OGTT: More than 200 mg/dl

HbA1c: More than 6.5 %

After making dietary and lifestyle changes he has managed to bring his blood sugar to normal range, that is what you have implied. In the best possible scenario, it means he has been able to bring his HbA1c and fasting to normal range. But Mr A will not pass the OGTT test.

Again in order to declare someone non-diabetic the above tests have to be repeated. Through diet and exercise it is possible to maintain blood sugar in a healthy range also called ' reversal 'of the conditions not cured. That means if Mr A goes back to his previous dietary and lifestyle practices, BG will again enter diabetic range.

The above can be confirmed by OGTT ( Oral Glucose Tolerance Test) where one is asked to ingest 75 gm of glucose test load and blood glucose is measured at two hour mark. A diabetic person will never pass this test, though his fasting and HbA1c are within healthy range through diet and exercise. That is why Mr A was declared diabetic with good control. I would say he is non-diabetic in practical terms or you can say he is a conditional non-diabetic. In day today life one is highly unlikely to consume 75 gm pure glucose in one meal. Therefore, he will never face that high blood glucose situation as long as he maintains his new dietary and lifestyle changes.

That also tells how important it is to reduce amount of carbohydrate including sugar in our diet.

2. Type 2 diabetes is a genetic disorder. That is why not all overweight and obese have diabetes and on the other hand many slim people also have diabetes.

However, it is not necessary that the genetic disorder will manifest into full blown diabetes, at least in majority of the cases. But it is possible to provide this genetic disorder a fertile ground to become a full-blown diabetes by WRONG CHOICE OF FOOD AND SEDENTARY LIFESTYLE WHICH WE ARE WITNESSING NOWADAYS.

[ramana42 Volunteer]

Makes sense."A' was a diabetic but could achieve non diabetic levels.If he gets slack in his efforts later on,his sugar levels are likely to spike.His diabetes is under remission/latent and may resurface again.He needs keep monitoring regularly.His status could be better understood if we study his family history of diabetes.In the case of B,at this point he is not diabetic,but his future is an unknown factor.

[Hidden]

Yes. That's what medics mean when they say "x%" of "known"diabetics! So in "A's" case hyperglycemia was detected so he will be advised to get his HbA1c and oral glucose tolerance test and host of other tests done. If all reports are above normal limits then diagnosis of Diabetes mellitus will be established. Whereas no such procedure will be followed for "B" because his blood sugar levels were in normal limits. B may or may not be a diabetic, we don't know bexcuse he didn't undergo confirmatory tests; because it's not practical for everyone to go for confirmatory tests unless preliminary screening shows positive impression. Therefore for all practical purposes "B" is non-diabetic.