CGMs Add Value in Reversal of T2D but are not Indispensable!

Abstract

Diabetes is a very common condition known to humans for generations. It can turn into serious complications and medical conditions involving various organs. There are two main types of diabetes. In type 1 diabetes, our body can’t make any insulin at all, but type2 diabetes is a life-long, chronic disease in which the body either does not produce enough insulin or the cells in our body don’t respond to insulin correctly. Despite its huge impact on the global population, there is still no cure for Type2 diabetes (T2D). The only known cure for Type 1 diabetes (T1D) is by either a pancreas transplant or a transplant of the specialized pancreatic cells that produce insulin. Recent research suggests that it is possible to reverse the T2D to a point where one may not need medication to manage it and our body does not suffer ill effects from hyper or Hypo- glycemia’s. Reversing diabetes refers to a significant long-term improvement in insulin sensitivity in people with diabetes. In practice to be termed as remission, or reversed or resolved a known diabetic patient’s blood sugar levels must remain normal for at least three months and get their HbA1c <42 mmol /mol (6%) without taking diabetes medications. Weight reduction, Diet management, exercises and therapy can cause type 2 diabetes to go into remission. That does not mean that diabetes will go away forever. Patients need to manage and monitor glucose levels to stay in remission! Reversing diabetes permanently is not possible. Primary care physicians have a key role in promoting Six Lifestyle changes to put diabetes into remission mode: i) Lose weight by 10-15% by any means ii) Exercise regularly for 30 minutes a day, iii) Monitor and maintain blood sugar levels and Hb1Ac within the target set, iv) Eat healthily to make up daily calorie’s requirements- 40% from carbohydrates, 30% from fat and 30% from protein with emphasis on vegetables and fruits. v) Quit smoking and vi) Get 7 hours’ sleep every night and manage sleep apnea if suffering. Blood glucose monitoring, the key issue in achieving reversal of diabetes depends upon devices. Regular glucometers and Continuous glucose monitoring devices are the tools used to monitor blood sugar levels. A lot of aggressive marketing of CGM devices has been seen in recent years. While it is a boon for people who can afford it, most of the developing world population can’t afford them, that should not hinder the progress towards diabetes reversal. This article is based on 2 case studies and literature review of approaches for diabetes reversal, Glucose monitoring devices and weight reducing measures. Materials & Methods: Two cases of diabetes, one autobiography of delayed weight reduction efforts and results and another a drastic weight reduction at early stage, both successes in their own way following key strategies without using CGM.