What is Remission?

Remission means keeping blood sugar levels in the non-diabetic range (HbA1c <6.5%)

without medication for at least 3 months. It’s not a cure — diabetes can return.

Is It Possible?

Yes — especially in early stages (first 5 years after diagnosis), with:

-Weight loss of 10–15% (via diet, exercise, or bariatric surgery)

-Low-calorie diets (under medical supervision)

-Intermittent fasting in selected cases

-Regular glucose and weight monitoring

Who is Most Likely to Achieve Remission?

-Diagnosed <5 years ago

-Overweight/obese (BMI >25)

-No insulin requirement yet

-Strong motivation and support system

What Doesn’t Work

-Unscientific detox diets

-Herbal “cures”

-Stopping medicines without guidance

Is It Sustainable?

In most cases, remission lasts 1–5 years — but relapse is common if weight is regained or

lifestyle lapses.

Take-Home messages:

Diabetes remission is achievable for few, not everyone. It requires consistent effort, medical

monitoring, and honest expectations.

References: ADA 2025 Standards of Care, RSSDI Guidelines 2024, DiRECT Trial

Not Just Sugar – It’s Complex Biology:

Type 2 diabetes develops when your body:

-Becomes resistant to insulin

-Can’t make enough insulin from the pancreas

What Causes It?:

Factor Role

Genetics Strong family history increases risk

Obesity Especially abdominal fat (visceral adiposity)

Inactivity Lowers insulin sensitivity

Poor diet High-carb, sugary, ultra-processed foods

Stress & ample Sleep

issues Disrupt hormones that regulate glucose

Can We Predict It Genetically?:

Not yet for individuals — but we know certain ethnicities (like South Asians) are more prone

due to higher fat-to-muscle ratio and insulin resistance even at lower BMIs.

Pathway Summary:

1. Insulin resistance increases

2. Pancreas compensates by overproducing insulin

3. Beta cells exhaust → sugar levels rise

4. Overt diabetes develops

Why Indians Get Diabetes at Lower Weights:

-Genetic “thrifty gene” hypothesis

-More visceral fat even at normal BMI

-Low muscle mass (“thin-fat” phenotype)

Take-Home messages:

You inherit genes, but you control your lifestyle. Even with risk, diabetes can be delayed or

avoided.

References: ADA 2025, RSSDI 2024, Endocrine Society of India