Diabetes is a lifelong chronic condition that can be managed but not cured.
Right?
Not necessarily. Recent studies suggest that treatments as varied as drug therapy, gastric bypass surgery and a super-healthy diet can actually reverse type 2 diabetes and curb or undo much of the damage caused by the disease, including retinopathy and kidney problems.
While physicians remain skeptical, researchers are hopeful that perhaps one day they will hit upon a silver-bullet treatment for a disease that affects 25.8 million people and is the seventh-leading cause of death in the nation.
Diabetes is metabolic disorder in which there is too much sugar in the blood. In a person without diabetes, glucose from food enters the bloodstream, prompting the pancreas to make insulin. The insulin moves the glucose from the bloodstream into the muscle, fat and liver cells, where it can be used as fuel.
In diabetics, the pancreas either doesn’t make the right amount of insulin or doesn’t respond normally to insulin — or both. The body is unable to properly use the blood sugar, and cells don’t get the energy they need to function and grow.
Diabetes is an epidemic in America. It is estimated that 1 in 3 people born in 2000 will develop diabetes in their lifetime, and the direct medical costs of diabetes in the nation add up to about $116 billion.
Among the most promising potential cures being touted now are a mix of the simple and the drastic.
TOTAL CHANGE OF DIET
It goes without saying that a disease so closely linked to excess weight can be kept at bay with a healthy diet. But that’s the problem: It has been going without anyone saying it, particularly the doctors charged with caring for diabetics, says Dr. Joel Fuhrman, author of “The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes.”
“The doctors think that if they say ‘diet and exercise,’ people won’t listen so we have to give them drugs,” Furhman says. “That just speaks to what a bad job they do. They don’t know how to teach and motivate people.”
Furhman’s book outlines a variety of nutrient-rich diets that he says have been proven to reverse diabetes. Chief among misconceptions perpetuated by doctors, he said, is the notion that people have to eat less. Instead, it is important to teach people to eat smarter.
“They have to eat more nutrient-rich food. If you try to cut back on calories, they can’t deal with the feeling,” he says.
Instead, patients should be taught to eat more beans, non-starchy vegetables (he’s a big fan of onions, garlic and mushrooms), nuts, seeds and berries. The more of these people eat, he reasons, the less they’ll crave white-flour based food, animal fats and sugar. And the less likely they will be to choose a course of treatment based on drugs.
BARIATRIC SURGERY
A funny thing started happening to patients undergoing gastric bypass surgery for weight loss: Many of them saw their diabetes disappear. In fact, several studies have published remission rates as high as 75%-80% in patients who previously had type 2 diabetes.
For nearly 15 years, diabetes doctors dismissed the results. These days, however, researchers are trying to figure out why gastric bypass surgery seems to work.
“A few years ago, it was quite common that at a major diabetes meeting, there might have been no mention of surgery in three-day forum. Now you look at the programs of these meetings and almost all of them include surgery as a major point of the scientific session,” says Dr. Philip Schauer, director of the Bariatric and Metabolic Institute at the Cleveland Clinic.
While promising, a 2012 Mayo Clinic study found that the disease can return in some 21% of bariatric surgery patients within three to five years, particularly in those patients who had had the disease for more than five years prior to surgery.
Still, many bariatric surgeons are convinced that for a good number of diabetes patients, surgery is the answer. Studies have found the surgery likely stimulates hormones that directly stimulate the beta cells of the pancreas to produce more insulin.
“You do not see that after a diet alone,” Schauer says.
DRUG THERAPY
One of the hormones stimulated in gastric-bypass surgery is glucagon-like peptide-1, or GLP-1. In a person without diabetes, the stomach uses the GLP-1 to warn the pancreas to make insulin when there is an increase in sugar in the blood.
While the hormone is usually produced in the small intestine, researchers found that in patients who underwent certain types of gastric bypass surgery, GLP-1 is made in the large intestine.
Intrigued, Steven Munger, a researcher and professor of endocrinology, diabetes and nutrition at the University of Maryland School of Medicine is now trying to figure out how to trigger that same response without surgery.
Munger says others who regularly work with common diabetes medications may be able to target current drugs to the large intestine where it could prompt GLP-1 production, or they may find a new drug to directly spur insulin production there.
As with any of the therapies being pursued to put a stop to diabetes, though, it is unclear whether drug therapy will provide a “cure” or simply slow the disease’s progression.
But those who believe in a cure see an end to diabetes just around the corner.
“Every person deserves to know that they don’t have to have diabetes for the rest of their lives,” Fuhurman says.