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Does HEAL Cure its Patients or Put Their Disease into Remission?

Not so long ago I was in a debate with a prominent endocrinologist who specializes in the treatment of diabetes. She did not have many patients who had lost weight, let alone changed their lifestyle, so she didn’t believe that “fixing diabetes” was possible because she hadn’t seen it. I pointed out that research published by a weight loss surgeon in the mid 1980’s convincingly showed that diabetes went away with effective weight loss. I also shared the clinical experience that I had, using lifestyle to fix diabetes. She agreed to debate what the correct terminology should be to describe someone whose diabetes went away after weight loss (by whatever means, lifestyle, medicine, or surgery).

Consider the case of someone who has high blood sugar levels and is on several medications to treat diabetes, but now has lost so much weight that there was no evidence of diabetes – no high blood sugar, no kidney, nerve, or eye damage. If one were not told that this person once had diabetes, you would not be able to find any evidence or trace of it. Because her diabetes had gone away, this person was no longer at risk for the long-term problems related to diabetes. I said that we could say this person has been cured. Like curing an infection or appendicitis, this person did not have diabetes anymore. Take it off the medical chart and insurance policy applications!

My colleague’s response was to say, “No, the diabetes is never cured–it is just put into remission. It will come back if the weight comes back.” However, wouldn’t an infection come back if there was exposure again? Yet we use the term “cured” when a disease goes away. I suppose the language “in remission” may be a motivator to a person that diabetes can come back if eating changes are not sustained. The literature is starting to use the language “diabetes in remission” if blood sugar levels are normal for one year. I prefer using the term “cure” to motivate people to make the change. The main point is that diabetes does not have to be permanent, or have an inexorable downhill course.

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    I am insulin resistant.. the endocrinologist kept increasing my insulin and my blood sugar kept going higher. Her dietitian says eat healthy carbs 45-60 grams “per meal”! well this didnt work. so I gradually decreased my Lantus to about a third of what I was taking.ate gluten/grain free for a year and BG’s were better but still in the 150-17- range so I have gone Keto; my BG is 80-124 and no Lantus.
    I feel great, bullet proof coffee and I don’t feel hungry. should I eat something even though I’m not hungry?

    • Eric Westman MD MHS

      Hi Peggy, The foundation of the HEAL program is to safely change the dietary carbohydrate and diabetes medications at the same time under the guidance and monitoring of a trained HEAL practitioner. Because HEAL protocols are individualized, I would advise seeing a HEAL practitioner. You can click the ‘Clinics’ or ‘Contact’ tab in the navigation menu to make an appointment or get more information.

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    Dr. Westman’s colleague commented, “No, the diabetes is never cured–it is just put into remission. It will come back if the weight comes back.” This could inadvertently mislead those of us who become pre-diabetic or diabetic at normal weights. I have not been obese since my early teens and was very slim when metabolic syndrome/prediabetes began. People like me tend to get fat around our abdominal organs but not on the outside, which hides the problem from us and our doctors (normal weight obesity). I suspect metabolic changes happen before obvious obesity in many, at least this is what I see in practice. The suggestion that obesity precedes diabetes may have the unintended consequence of lulling slender folks, like me, into complacency. Given that the Centers for Disease Control (CDC) reports 46.3% of American adults over age 20 has diabetes or prediabetes, and a significant percentage (1/3 of diabetics, e.g.) do not know it, it behooves all of us to pay attention to the signs and symptoms of metabolic syndrome; or, better yet, ditch refined carbohydrates and processed foods altogether. My two cents.

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    Sorry, had a bit of an agenda to get off my chest in previous comment. As for the Cure vs. remission debate, I think I prefer the remission label. If I think of being cured, then that immediately brings to mind that I can more freely eat carbs and sugars and I don’t want to get into thinking that way. It’s probably overdoing the sugars and carbs that caused my diabetes in the first place. I prefer to think of myself as being in remission from diabetes – which helps me to face the fact that I can’t eat sugary or carb laden foods. It feels very good to be in remission and I know that I am able to control it – it’s not the same as remission from cancer where you never know when it might return – the diabetes will not return so long as I exercise and eat the right foods. So I guess in that regard it is more like a cure. Still, I imagine that if I ate a packet of biscuits, my blood sugar would rise unacceptably, and a non-diabetic’s wouldn’t, so I can’t say I’m cured.

    • Ginger Namgostar

      More words of true wisdom, Steve! Couldn’t have said it better myself!

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    I’ve been a type 2 diabetic for 14 years and about a year ago, discovered the low carb diet. I’ve lost 15 kg and my blood sugar levels are normal. I’m very annoyed that the diabetes advisers and dieticians were encouraging me to eat “healthy” carbs for all those years. Even once I’d been on a low carb diet for months and had plenty of energy (work out in the gym daily and do lots of physical work) several diabetes “experts” told my I’d have no energy on a low carb diet. The truth is that anyone with diabetes is carbohydrate intolerant and should avoid it as strenuously as gluten intolerant people avoid gluten. I now have much more energy than I ever had on their recommended diet of “healthy” low gi carbs. There is no such thing as an essential carb, just stop eating them.

    • Ginger Namgostar

      Perfectly stated! I think your comment: “The truth is that anyone with diabetes is carbohydrate intolerant and should avoid it as strenuously as gluten intolerant people avoid gluten” really hit the nail on the head. This type of education truly needs to be spread. Thank you for your words of wisdom, Steve!


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Disclaimer: This website does not provide medical advice or treatment. Follow the guidance of a physician before embarking on any diabetes-management or weight-loss program, especially if you are on dialysis, pregnant, nursing or under the age of 18. If you are taking medications, changing your diet under the HEALcare® program may require a change in their dosages. Follow your doctor’s orders on all medications, especially if you are taking diuretics or medication for blood pressure or diabetes. Individual results may vary. The testimonials referenced in this website are not promises or guarantees that you will achieve similar results.

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