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.
But some people pushing whatever diet caused them to lose the weight will call the type 2s who stop using insulin "cured" because they're off insulin. They're not cured. They're simply better controlled.
Here are a few examples of "miracle cures":
According to the book Reversing Diabetes, the 1987 edition, a Mr. R. K. came to the Whitaker Wellness Institute with a fasting BG level of 93 on 130 units a day NPH insulin, a lot of insulin. After 6 months of the institute's diet, he was taking no diabetes medications, and his fasting BG was 91. The author writes, "His diabetes and high blood pressure had disappeared -- a miracle cure"
There's no question that he was doing better, because he was able to maintain the same fasting BG level without insulin. But there's no information about what his BG levels were after eating the low-fat, high-carbohydrate diet. Nothing about his average BG level as reflected in his hemoglobin A1c.
I doubt that his diabetes had "disappeared." It was simply better controlled. The author considered this a miracle cure because his fasting level was at a high-normal level. (Anything above 100 is considered prediabetes.)
According to an Internet site selling Eleotin, a mixture of herbs promoted as a diabetes cure, Ms. B first bought Eleotin for her mother. When she started, her "blood glucose level" (doesn't say if it's fasting or after meals) was over 200. Six months later in June, her blood glucose level ranged from 150 to 165.
That's a cure? BG levels from 150 to 165? If those are fasting levels, they'd constitute a diabetes diagnosis even decades ago, when standards were more lax.
According to an Internet site selling Vitacel, a "natural cure," which turns out to be metformin, a patient said, "I have had diabetes for 15 years taking insulin twice a day, 40 units in the morning and 45 units in the evening for Diabetes management of the symptoms. At that time my sugar count was 380 to 400. . . My sugar count is now 149 and I feel great."
Again, her BG levels are better, but she's not cured. Furthermore, she's taking a standard generic prescription drug.
According to another Internet site selling a "natural cure: diabetes," "I am a 38 yr old diabetic woman. I take injections 4 times a day. I've always been afraid to exercise because I thought it would be bad for me. After reading your book I realized that exercise is good for me and I've joined a local walking group. Besides feeling better, I have made some wonderful new friends."
Gosh, I think it's wonderful this woman has a lot of new friends, but does that constitute a diabetes cure? Not in my book.
Some of these "cures" may bring down BG levels through a placebo effect. The patient expects them to work, so they do. Enthusiasm about a new treatment also sometimes gives a patient a temporary feeling of well-being, and more energy.
But they also may help because the information that comes with the "cure" will say it works best if you follow some diet, or, as with the woman who has a lot of new friends, exercise program, and being very enthusiastic about their new "curative" treatment, they stick to the diet and exercise at least for a little while.
Another possibility for "wonder cures" is that they've been adulterated with real diabetes drugs like metformin or sulfonylureas. Or they could contain herbs that are natural sulfonylureas. Metformin, after all, was developed on the basis of an herb called goat's rue that has been used since the Middle Ages to treat people with diabetes. But it also had bad side effects, and derivatives with the beneficial properties of goat's rue but fewer of the side effects were developed.
A diabetes site in India says that many of the "natural cures" being sold there actually damage the liver, and because it is damaged, it can't produce glucose through gluconeogenesis, so BG levels decline. Personally, I don't think I want to cure my diabetes by trashing my liver.
However, one must remember that even if some drug improves your BG levels, or even if some diet brings your BG levels back to normal ranges, you're not cured. Being cured doesn't mean you have great BG levels while you're following some kind of treatment. Being cured means you can maintain normal BG levels after you eat whatever you want, including cotton candy, while taking no treatment at all.
Some type 2s who are diagnosed in the very early stages and lose a lot of weight and get a lot of exercise can, indeed, reach this state. They are in a sense cured. But if they regain the weight, or even if they just have the normal beta cell deterioration that comes with aging, they are most likely to become diabetic again. Whether or not they are diabetic in the meantime is a question of semantics and not worth discussing.
Someday we'll have a real cure, but I'm afraid I don't expect to see a cure soon. So until that day comes, when you read about some new wonder drug that will cure diabetes, don't believe it. If you don't believe me (and skepticism is good), then read the claims carefully.
Check out the sources of any "cures" you see advertised. If they're from companies you've never heard of, the chances of getting what you think you're getting are slim.
Finally, compare the prices with the prices of generic diabetes drugs. Generic metformin is not expensive. In some countries it's about 25 cents a pill. Sulfonylureas are also not expensive. Some "miracle cures" cost hundreds of dollars a month. I doubt that most people take them for more than a few months, but there are always new believers coming along.
Don't be one of them. Don't waste your energy looking for miracle cures. Instead, take that energy and use it to take a walk. Buy delicious, nutritious food. Take what medication you need to control your BG levels. Find the best, most empathetic physician you can find to help your control. Keep track of your hemoglobin A1c and other aspects of your overall health like blood pressure and lipid levels.
You'll be much healthier than the people throwing their money away on diabetes "cures."