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What is type 2 remission?

Type 2 diabetes remission is when your long-term blood sugars fall below the diabetes level and stay there for at least three months, without the need for glucose-lowering medication. 

In medical terms, this means having a HbA1c below 48mmol/mol or 6.5%. This definition has been agreed by a team of international experts from here at Diabetes UK, the American Diabetes Association, and the European Association for the Study of Diabetes.

Diagram showing two test tubes of blood with an arrow to the left showing that under 6.5 is a remission range, and arrow to the right showing above 6.5 is a diabetes range.

By bringing your blood sugars into a non-diabetes range long-term, the symptoms of diabetes and any new damage it can do to your body are on pause. This doesn't mean your diabetes has gone away forever as your blood sugar levels can rise again. And you still need to make sure you attend regular check-ups and get the support you need to treat or manage any existing diabetes-related complications. But it does mean that you are more likely to feel better and see improvements in your health long-term. 

My health declining is what scared me when I was diagnosed with type 2 and it made me try and see what could be done. I’ve changed that now, I am in remission and I am very happy. – Read more of David's remission story

Benefits of type 2 diabetes remission

Being in remission and having blood sugar levels below the diabetes range long-term can reduce your chances of developing diabetes-related complications, like heart attacks, strokes and diabetes-related sight loss.

For some people, putting their type 2 diabetes into remission can help lower their blood pressure, cholesterol and body weight. All of which can have a huge impact on your everyday health and wellbeing, and your long-term health. 

The everyday benefits can include: 

  • taking fewer medications 
  • having more energy and sleeping better. 
  • feeling like you have more control over your body. 

The long-term benefits can include: 

  • less risk of heart attack and stroke 
  • less risk of avoidable sight loss  
  • less risk of amputations   

How these long-term benefits work

When your blood sugar levels and blood pressure are lower, this reduces the damage they can do to your blood vessels.

Damaged blood vessels in the heart can cause heart attack and strokes. Damaged blood vessels in the eyes can cause diabetes-related sight loss. And damaged blood vessels in your hands and feet can affect the blood flow to these limbs. This can cause problems that can lead to amputations. 

Having lower blood sugar levels, blood pressure and cholesterol levels can help reduce your risk of getting these complications. In fact, any improvements in these levels can reduce your risk, whether you go into remission or not. 

"For me it has not been about just escaping type 2 diabetes; remission comes with so many other benefits, like coming off your diabetes medication and not feeling joint and back pain. Just having a healthier outlook on life and your wellbeing." – Read more about Peter's story.

How type 2 diabetes remission works

We know that remission is a possibility for many people living with type 2 diabetes. And the strongest evidence we have suggests that type 2 diabetes is mainly put into remission by weight loss. 

We don't know enough to say if weight loss will lead to remission for everyone though. There are people who haven't been able to get their blood sugar levels below the diabetes range without the need for medication, no matter how hard they've tried. The causes of type 2 diabetes are multiple and complex. But we do know that in many cases it's caused by a build-up of fat inside the liver and pancreas.

Why are my liver and pancreas are important?

Your liver and pancreas are vital organs that control your blood sugar levels. The pancreas is responsible for making insulin, a hormone which lowers your blood sugar levels. The liver keeps your blood sugars steady by storing and releasing sugar, also known as glucose, when needed.

But a build-up of fat in the liver and pancreas can stop them from working properly to keep your blood sugar levels in a safe, non-diabetes range. Losing weight can help reduce the amount of fat stored in these organs and kickstart them into managing your blood sugar levels again. For some people this means they can stop taking medications that lower their blood sugar levels and go into remission from type 2 diabetes.

How do I know if I have a build up of fat?

There’s no easy way of knowing how much fat is stored in your liver and pancreas. You can’t tell by looking at someone’s weight or body size. That’s because regardless of our weight or size, we all have different levels of fat that we can safely store before the fat affects how the liver and pancreas work. The only way to reduce the excess fat is to lose weight.

For more information on what the research says about how type 2 remission works, take a look at our remission research page

Why we don't call it 'reversing' type 2 diabetes

Type 2 remission is called ‘reversal’ by some people, but we think that the word remission is more accurate. The NHS uses the word remission too. 

The reason we call it remission is because ‘reversal’ can make it sound like your diabetes is cured or has gone away. And because of that people may stop going for their diabetes checks.

But when you’re in remission your diabetes has not gone away completely so you still need your checks. There are two main reasons for this:

  1. Being in type 2 remission stops the diabetes from doing any new damage to you and your body. But you may have damage caused by high sugar levels from before you went into remission. Diabetes eye screening and checks for kidney disease are ways to check for signs of diabetes-related problems.
  2. Staying in remission can be hard. Some people stay in remission for years but others find that their blood sugars rise again after a time, and they come out of remission. Your doctor or diabetes nurse will monitor your blood sugar levels to help you take action if your blood sugar levels do rise again.

"When I went into remission, I was so happy. They tell you you’re never ‘cured’. You’re in remission, because your diabetes can come back at any time." – Read more about Fatima's story

The chances of going into type 2 diabetes remission

We are still learning how to support everyone with type 2 diabetes to go into remission. Many people who have tried for remission have gone into it. Some people who have tried haven't gone into remission. But we know that:

  • The chances of remission are better the sooner you try after your type 2 diagnosis.
  • If you are living with obesity, your type 2 diabetes is more likely to go into remission if you lose around 15kg (or 2 stone 5lbs) of weight as quickly and safely as possible following diagnosis.
  • You can go in and out of remission. Some people stay in remission for years. Others find that their blood sugar levels rise again after a time if they regain weight, and they come out of remission.
  • Staying in remission can be tough. You need to be supported to keep your weight at the level that is right for you, which prevents fat building up again in your liver and pancreas.
  • Any time spent with your blood sugar levels below the diabetes range can have benefits. And, if you do come out of remission, it is possible to get your blood sugar levels back down to a non-diabetes range..
  • Whether you go into remission or not, working towards it and losing weight brings about many other health benefits.

 

"Losing all that weight and being in remission felt great, both physically and mentally.

I can only describe my initial feelings as a positive regret that I didn’t address my weight years ago." – Peter

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