Until 2010, diabetes was considered a lifelong disease, and even after treatment to the point where blood glucose remained normal without any medication, professional diabetologists could not say it was cured because there was no definition of a cure. It was not until November 2009 that the American Diabetes Association officially published a Diabetes Association Expert Consensus, which gave a specific definition of a cure for diabetes, discussing at length whether to use the word “cure” or “remission”. Because “curing” diabetes is a new concept and whether it will recur in the future is still a mystery, the experts agreed to use the word “remission” to describe the above state, and divided remission into three cases, as defined below: 1. Partial remission Partial remission: ①Hyperglycemia below diagnostic thresholds for diabetes ②Lasting for more than 1 year’s duration ③No No active pharmacologic therapy or ongoing procedures 2. complete remission ①Normal glycemic measures ②At least 1 year’s duration ③No active pharmacologic therapy or ongoing procedures 3. prolonged remission Complete remission of at least 5 years’ duration) What is the cure for type 2 diabetes? Current research shows that there are three main methods that can bring some patients into remission or long-term remission: 1: Bariatric surgery: Bariatric surgery can bring a significant number of type 2 diabetes into remission or long-term remission, but bariatric surgery is only suitable for some diabetic patients. Chinese Medical Association, Division of Diabetes.
Expert consensus on surgical treatment of diabetes mellitus. Chinese Journal of Diabetes, 2011, 3(3):205-208), which clearly put forward the indications for bariatric surgery for the treatment of diabetes: ①Body mass index (BMI) ≥35
kg/m2 with or without comorbidities in the T2DM subpopulation, bariatric surgery can be considered. ②BMI 30 to 35
kg/m2 with T2DM, bariatric surgery should be one of the treatment options when lifestyle interventions and pharmacotherapy are difficult to control blood glucose or complications, especially when cardiovascular risk factors are present. ③BMI
28.0 to 29.9 kg/m2 in Asian populations with comorbid T2DM and centripetal obesity (waist circumference >85 cm in women and >90
cm) and meet at least 2 additional criteria for metabolic syndrome: hypertriglyceridemia, reduced HDL-cholesterol levels, and hypertension. Bariatric surgery may also be considered as a treatment option for the above patients. ④ For patients with BMI ≥40
kg/m2 or ≥35
kg/m2 with severe comorbidities, and for adolescents aged ≥15 years with mature skeletal development and a Tanner developmental classification of 4 or 5, bariatric surgery may also be considered as a treatment option with the patient’s informed consent. ⑤ For BMI
25.0 to 27.9
kg/m2, T2DM patients should undergo surgery with the patient’s informed consent, strictly according to the study protocol. However, the nature of these procedures should be considered purely as part of a pilot study approved in advance by the ethics committee only, and should not be widely promoted. (6) Patients with T2DM who are <60 years of age or in good general health with low surgical risk. In addition, the consensus also details contraindications to bariatric surgical treatment, risk of surgical death, complications, preoperative and postoperative management, and emphasizes the importance of dietary guidance. Body mass index (BMI) = weight (kg)/height2 (m). 2: Stem cell therapy: Stem cell therapy for diabetes can only lead to remission in a small percentage of patients, the mechanism of treatment is unclear, and the treatment remains to be further evaluated. 3: Appropriate medication for the patient's specific condition: Many studies have confirmed that appropriate medication for the patient's specific condition can bring a significant number of newly diagnosed type 2 diabetic patients into remission or long-term remission, because most newly diagnosed diabetic patients' pancreatic cells are not yet dead, but only damaged, and if appropriate medication is given in time, the damaged pancreatic cells can Therefore, there are many more patients in remission or long-term remission than those with long duration of disease. For example, we use the advanced "Double C
program”
and “optimal combination of multi-dose hypoglycemic drugs”, we have successfully enabled some diabetic patients to achieve the goal of normal blood sugar without any drugs, eliminating the pain of lifelong medication, especially for newly discovered diabetic patients, the effect is excellent, and the remission or cure rate is as high as 30-70% (the remission rate is high for those who are young, have a short disease duration and are heavy). ), to achieve the purpose of “beyond glucose lowering, comprehensive control”.