HOW TO CONTROL DIABETES
There is no cure for diabetes. Neither type 1 (juvenile onset or insulin-requiring) diabetes or type 2 (adult-onset) diabetes ever goes away.
In type 1 diabetes, patients sometimes experience what physicians have come to call a "honeymoon period" shortly after the disease is diagnosed. During the "honeymoon period" diabetes may appear to go away for a period of a few months to a year. The patient's insulin needs are minimal and some patients may actually find they can maintain normal or near normal blood glucose taking little or no insulin.
It would be a mistake to assume that the diabetes has gone away, however. Basically, type 1 diabetes occurs when about 90 percent of the body's insulin-producing cells have been destroyed. At the time that type 1 diabetes is diagnosed, most patients still are producing some insulin. If obvious symptoms of type 1 diabetes emerge when the patient has an illness, virus or cold, for example, once the illness subsides the body's insulin needs may decrease. At this point, the number of insulin-producing cells remaining may be enough — for the moment — to meet the person's insulin needs again.
But the process that has destroyed 90 percent of the insulin-producing cells will ultimately destroy the remaining insulin-producing cells. And as that destruction continues, the amount of injected insulin the patient needs will increase — and ultimately the patient will be totally dependent on insulin injections.
Scientists now think that it is important for people with newly diagnosed diabetes to continue taking some insulin by injection even during the honeymoon period. Why? Because they have some scientific evidence to suggest that doing so will help preserve the few remaining insulin-producing cells for a while longer.
Patients diagnosed with type 2 diabetes may discover that if they are overweight at diagnosis and then lose weight and begin regular physical activity, their blood glucose returns to normal. Does this mean diabetes has disappeared? No. The development of type 2 diabetes is a gradual process, too, in which the body becomes unable to produce enough insulin for its needs and/or the body's cells become resistant to insulin's effects. Gradually the patient goes from having "impaired glucose tolerance" — a decreased but still adequate ability to convert food into energy — to having "diabetes."
If the patient were to gain weight back or scale back on their physical activity program, high blood glucose would return. If they were to overeat at a meal, their blood glucose probably would continue to go higher than someone without diabetes. Also, the decreased insulin production and/or increased insulin resistance that led to the initial diabetes diagnosis will gradually intensify over the years and during periods of stress. In time, the patient who could maintain normal blood glucose with diet and exercise alone may discover that he or she needs to add oral diabetes medications — or perhaps even insulin injections — to keep blood glucose in a healthy range.
The good news for a type 1 and type 2 patient is that if insulin, medication, weight loss, physical activity and changes in eating result in normal blood glucose, that means their diabetes is well controlled and their risk of developing diabetes complications is much lower. But it doesn't mean that their diabetes has gone away.
