Wouldn't it be nice if we could all be cured of our diabetes. Of course it would.
But except for treatments involving major surgery -- pancreas transplants (and the anti-rejection drugs are considered more dangerous than having diabetes, so they won't do this procedure unless you also need a new kidney) or gastric bypass surgery (which means you'll never be able to eat normally again, and you may suffer from nutritional deficiencies) -- real cures are not yet available.
Yet we're always hearing about amazing diabetes "cures" in the popular press, and ads for diabetes "cures" are everywhere.
What's going on here?
Well, first of all, you have to understand what all these people mean by "curing" diabetes. In the old days, they diagnosed diabetes by seeing if you were spilling glucose in your urine. No glucose in the urine meant you didn't have diabetes. So if you went on a diet and stopped spilling glucose, you were considered cured.
But most people have to reach blood glucose (BG) levels of 180 or more to spill glucose in the urine. So you could have BG levels of 160 all day long and still be considered cured by those standards. And having a BG level of 160 all day long is enough to cause complications.
Some people don't spill glucose in the urine until they reach even higher BG levels, maybe 200 mg/dL or even more. They'd be running even higher BG levels without showing urine signs of diabetes. They'd be considered "cured" while progressing on toward serious complications.
Other people consider that you're cured if you no longer need to take insulin. If you were a real type 1 and you got off insulin, of course something miraculous would have occurred. Most likely, this "miracle" would be a misdiagnosis in the first place. There are people with what's called "maturity-onset diabetes of the young," or MODY, who were diagnosed with diabetes as children. Because type 1 diabetes used to be assumed to be the cause whenever diabetes appeared in children, these children were told they had type 1 and were prescribed insulin shots.
Now they've found that many of these people do very well with small doses of sulfonylurea drugs. So are they cured? No. They're simply taking a different treatment.
Many type 2s don't control their disease well and need to use insulin. If they can improve their insulin resistance through diet and exercise, however, they can often stop using the insulin and switch to oral drugs, or even -- if they are able to lose a lot of weight -- no drugs at all.
This is mostly true for people who were diagnosed in the very early stages of type 2, in which their beta cells are still able to produce a lot of insulin themselves, just not enough to overcome the extra insulin resistance caused by the excess weight. People who are diagnosed at later stages, when their beta cells are really exhausted, can lose hundreds of pounds and still need the drugs or insulin.
