Trying remission safely - why you should speak to your healthcare team
There are four main reasons why it’s important to speak to your healthcare team about going into type 2 remission and staying there:
Type 2 remission isn't right for everyone
Losing weight for remission is individual to you
You may need to make changes to medications you take
You still need diabetes health checks when you’re in remission
Whether you’re thinking about trying to go into type 2 diabetes remission, already attempting it, or your type 2 diabetes is in remission, it’s incredibly important to have conversations with your healthcare team. You need advice and guidance that is personalised to your circumstances and right for you.
"The diabetes nurse from my GP practice got in touch and said given how much weight I had lost she thought my HbA1c test needed to be repeated. If my HbA1c was coming down, then I shouldn’t be increasing my metformin dose." – Read more about Sean's type 2 remission story.
Type 2 remission isn't right for everyone
Type 2 diabetes remission has many benefits. But if you have certain health conditions in addition to type 2 diabetes, it might not be right or safe for you. You should speak to your healthcare team to discuss your circumstances.
Your healthcare team can tell you if:
- it’s medically safe to try putting your type 2 diabetes into remission through a particular diet.
- whether it’s safe for you to come off diabetes medications when your blood sugar levels are low enough to go into remission.
Some diabetes medications can do more than just lower blood sugar levels. Some can provide extra protection against heart or kidney disease. So, for people who are at higher risk of these, there might be added benefits to taking diabetes medication. And your healthcare team might say you should stay on some diabetes medications.
You don't need to come off medications to benefit from moving towards remission though. There are lots of benefits from having lower blood sugar levels and body weight. So, if you need to remain on medication, you’re still likely to reduce your risk of diabetes-related complications.
Losing weight for remission is individual to you
How much weight you may need to lose to try going into type 2 diabetes remission is completely individual to you. So is how you lose weight.
Your healthcare team can give you guidance on balanced diets that can help you manage your diabetes and lose weight. This can include information on the food and drink you may want to try, portion control, and the timing of meals. These are all important for managing weight and blood sugar levels.
And if you have other health conditions alongside your diabetes, your healthcare team will consider these too.
Losing weight and being in remission can involve making big changes to your diet and activity levels. Your healthcare team can give you support and guidance to help you stick to healthy habits. This may include strategies for managing stress, coping with emotional eating, and maintaining a positive mindset as you move towards remission and try to stay in it.
If you’re of a healthy BMI, losing too much weight could put you in the underweight category. And being in the underweight category can weaken your immune system, putting you at greater risk of getting infections. It can also affect your bone strength, making bone fractures more likely.
You may need changes to medications you take
It’s vitally important to speak to your diabetes healthcare team before making any changes to your diet and activity levels. They need to advise you on any adjustments you may need to make to any medications you take.
This is because starting a new diet may make a difference to the amount of carbohydrates you eat. And the carbohydrates have the biggest impact on your blood sugar levels.
If you're taking insulin or diabetes medication that increases your risk of hypos like sulphonylureas, reducing the amount of carbs you eat or losing weight without adjusting the medications could lead to your blood sugar going too low, known as a hypo.
If you’re taking SGLT2 inhibitors like Dapagliflozin, Canagliflozin, Ertugliflozin or Empagliflozin, reducing the amount of carbs you eat without adjusting the medication could lead to a very serious diabetes health condition called ketoacidosis. This is when your blood sugar levels are dangerously high and urgent medical treatment is needed.
Losing weight can also make a difference to medications you may be taking for other health conditions alongside diabetes. People who lose weight when trying for remission can see a lowering of their blood pressure so if you’re taking blood pressure medication, this may need to be adjusted.
You still need health checks if you're in remission
When you’re in remission it’s likely you have reduced chances of developing new diabetes-related complications. But we don’t know it’s impact on diabetes-related complications that you already have. Or new complications that may develop from when your blood sugars were in the diabetes range.
That is why, when in remission, you need regular health checks such as diabetic eye screening and checks on your blood pressure, cholesterol, kidneys, and weight, to spot any new problems and ensure these and any existing complications are monitored and treated properly.
We know that for various reasons, people go in and out of remission too. Your healthcare team should regularly monitor your blood sugar levels. Having these checks can make sure you get support and treatment as soon as possible if your blood sugars rise again.
Some people tell us they’re reluctant to try going into type 2 diabetes remission because they’ve heard that being in remission means their GP will class their diabetes as inactive, and they’ll stop getting support. You should be coded by your GP as being “in remission” and continue to receive your annual diabetes checks to monitor and get treatment for existing diabetes-related complications if you have them, and pick up on any new ones.
"I’m in remission now but I am fully aware that I still need to keep an eye on things. The nurse told me to keep up the healthier lifestyle and go back for an annual blood test, which is exactly what I’ll do. For now though, I’m really proud of what I’ve achieved and I’m looking forward to enjoying a healthier future." – Sean
