Marketplace Commentary: Reverse diabetes? How about we manage it.

By Manny Hernandez – SVP, Member Experience

I was diagnosed with diabetes in 2002, and for well over ten years, I have been a very active and vocal diabetes advocate. One of the things I have seen pop up periodically in the past 15 years are claims of treatments and approaches that are supposed to reverse or cure diabetes.

Before going any further, a couple of key definitions from the American Diabetes Association:

    • “If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn’t able to keep up and can’t make enough insulin to keep your blood glucose at normal levels.” Up to 95% of people with diabetes live with type 2 diabetes.
    • In type 1 diabetes, the body does not produce insulin. Only 5% of people with diabetes have this form of the disease.”

Except in the case of people with type 2 diabetes who undergo bariatric surgery (about 70% of whom experience remission within 5 years after surgery), diabetes cannot yet be cured. There are extraordinary efforts led by JDRF, the American Diabetes Association, Diabetes Research Institute and other organizations to change this. But diabetes is a chronic condition: when you get diagnosed with it, you will live with it for the rest of your life.

Today, there are startups making bold claims that they can cure type 2 diabetes through the adoption of a ketogenic diet, which requires the individual to eat less than 30 grams of carbohydrates (the equivalent of 1 glass of orange juice) per day. If this sounds extreme, it’s because it is. 90% of people that start on this diet are not able to stick to it after a few years. This is consistent with the observations of leading diabetes educators like the former president of the AADE (American Association of Diabetes Educators), Hope Warshaw.

Whether you stick with a ketogenic diet or stop leading this lifestyle, your diabetes isn’t cured. And this is what concerns me most about the use of the words “reversal” and “cure” in connection to lifestyle. There are instances where type 2 diabetes can be reversed without surgery, but by and large, diabetes reversal is very rare. In this 2012 study, only 6 people of 120,000 adults with type 2 diabetes sustained remission after 7 years.

Definitely, a ketogenic diet as part of lifestyle change can be a great approach for some people in helping them manage their type 2 diabetes, for as long as they can stick to it. But taking a 10-week study done on 238 people and claiming that this approach is the cure for diabetes is going too far.

That’s why at Livongo, we do not believe in a one-size fits all approach. From the personalized messages you get on your meter after every blood glucose reading to the access to Certified Diabetes Educators that will fit your schedule and your needs, all the way to the insights our Data Science team keeps unearthing so that you can have an experience that speaks to you. We too are eager for the cure.  And would happily change our business focus when it happens.  But in the meantime, we give Livongo members the tools and support they need to live better lives.