Type 2 Diabetes Remission: What It Means for Women Over 40
When we hear the word “remission,” we often associate it with cancer—a state where cancer is inactive but not necessarily cured. Similarly, experts recommend using the term remission when describing Type 2 diabetes to emphasize that while symptoms can improve significantly, the condition may not be entirely “cured.”
You may have heard terms like “reversal,” “resolution,” or “cure” in relation to Type 2 diabetes. But what do these terms really mean, and which is most accurate for women navigating midlife and menopause?
Reversal or Remission? Why the Distinction Matters
I often use the term reversal because it reflects the ability to significantly reduce or even eliminate the symptoms of Type 2 diabetes and lower the risk of complications. However, it’s important to note that for some individuals, particularly those who have had diabetes for more than 10 years, the body may lose its ability to produce insulin entirely, making insulin therapy necessary.
On the other hand, the term cure should be avoided because diabetes-related risks cannot always be eliminated entirely. Factors like age, genetics, family history, and ethnicity continue to influence risk, regardless of blood sugar control.
A recent consensus report published in the Journal of Clinical Endocrinology and Metabolism emphasized this distinction, concluding that “remission” is the most appropriate term. Remission recognizes that Type 2 diabetes may not always be active or progressive but acknowledges the potential for recurrence if lifestyle changes are not maintained.
How Is Remission Defined?
The consensus report established specific criteria for remission:
- A1C of 6.5% or lower for at least three months without the use of glucose-lowering drugs, including metformin.
- For individuals where A1C is unreliable (e.g., certain anemias or other red blood cell conditions), remission can also be defined by:
- An average glucose level equivalent to an A1C <6.5%, measured over 24 hours using continuous glucose monitoring (CGM).
- A fasting blood glucose level below 126 mg/dL for at least three months without medications.
These results should be confirmed through repeated testing to ensure sustained remission. Even after achieving remission, experts recommend regular A1C testing (at least annually) and ongoing screening for diabetes-related complications.
*(Source: Journal of Clinical Endocrinology & Metabolism, 2021 Consensus Report)
The Unique Challenges of Midlife and Menopause
For women over 40, achieving and maintaining remission comes with unique challenges. Hormonal changes during menopause can increase insulin resistance, leading to:
- Weight gain, especially around the abdomen.
- Disrupted sleep, which can raise blood sugar levels.
- Increased stress, which affects overall glucose control.
These changes make managing diabetes more complex, but not impossible. By focusing on stabilizing hormones, improving sleep, and reducing stress, women in midlife can still work toward remission.
Pathways to Type 2 Diabetes Remission
Several interventions can help women achieve remission, including:
- Lifestyle Modifications
- Diet: Transition to a whole-food, plant-forward diet emphasizing non-starchy vegetables, healthy fats (e.g., olive oil, nuts), lean proteins, and minimal processed foods.
- Physical Activity: Aim for at least 150 minutes of moderate-intensity exercise weekly, including resistance training to improve muscle sensitivity to insulin.
- Stress Reduction: Incorporate mindfulness, yoga, or other stress management techniques to reduce cortisol levels, which can affect blood sugar.
- Improved Sleep: Prioritize 7–9 hours of quality sleep to support metabolic health.(Source: American Diabetes Association Guidelines, 2023)
- Surgical Interventions
For individuals with obesity and poorly controlled diabetes, metabolic surgeries like gastric bypass can promote significant weight loss and lead to remission. Studies show that up to 60% of individuals achieve remission within 1–3 years after surgery. (Source: International Diabetes Federation Report, 2022) - Medications and Functional Supplements
Certain medications, like GLP-1 receptor agonists (e.g., semaglutide), and supplements, such as omega-3 fatty acids and vitamin D, may support insulin sensitivity and reduce inflammation. Always consult a healthcare provider before starting new treatments.
How Long Does It Take?
The timeline for remission varies based on the intervention:
- Lifestyle Changes: For those using diet and exercise alone, achieving stable A1C reductions can take up to 6 months.
- Surgical Interventions: Metabolic improvements typically stabilize within 3 months.
For women over 40, progress may feel slower due to hormonal fluctuations, but consistency and persistence yield results.
The Functional Medicine Perspective
Functional medicine emphasizes addressing the root causes of insulin resistance, including poor diet, chronic stress, and sleep deprivation. By making targeted changes, it’s possible to reduce inflammation, improve gut health, and achieve sustainable blood sugar control.
Key focus areas include:
- Anti-Inflammatory Diets: Minimize processed foods and sugar while increasing nutrient-dense, whole foods.
- Gut Microbiome Health: Incorporate fermented foods (e.g., yogurt, kimchi) and fiber-rich options to improve digestion and insulin sensitivity.
- Stress Management: Chronic stress exacerbates insulin resistance, so practices like mindfulness and breathing exercises are crucial.
For more on this, check out my post “What Are the True Causes of Chronic Disease?”.
Living in Remission: A Lifelong Journey
Achieving remission is not the end of the journey but the beginning of a new chapter. To sustain remission:
- Continue regular A1C monitoring and screenings for complications.
- Maintain healthy lifestyle habits, including a balanced diet, exercise, and stress management.
- Seek support when needed, whether through health professionals or supportive communities.
For women over 40, remission is more than a clinical milestone—it’s an opportunity to reclaim health, vitality, and confidence. By understanding your unique needs and making sustainable changes, you can achieve and maintain remission, transforming your health for the better.