This is a million dollar question by many. But, Unfortunately, the concept of “cure” doesn’t seem to apply to diabetes. That’s because diabetes isn’t a single disease, but a collection of different disorders, some of which are autoimmune, most of which are genetic, and all of which involve either the destruction of the pancreas’ ability to make insulin, or the body’s ability to use insulin appropriately (or both).
Examples of the different types of diabetes that would need different
approaches to be cured: type 1 (autoimmune) diabetes, type 2 (insulin-resistant) diabetes,
MODY diabetes (which is actually a name
covering at least a dozen different monogenetic
forms of diabetes), post-surgical diabetes (after
pancreatectomy surgery), bronze diabetes
(medically called hemochromatosis), chemically-
induced diabetes (such as the diabetes induced
by Agent Orange) and Cystic Fibrosis-Related
Diabetes.
Therefore, any cure that eventually might be
developed would probably only affect a
percentage of the people who have one of the
various forms of diabetes, and wouldn’t be likely
to cure any of the other types of diabetes.
diabetic8In 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.
diabteic9But the process that has destroyed 90
percent of the insulin-producing cells will
ultimately destroy the remaining insulin-produci
ng 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.
diabetic1Patients 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
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