"The issue is one of definition, and whether or not you've reversed diabetes or are simply controlling it," Ratner said.
Rates of remission decreased as the intensive program wound down, and Ratner said that "suggests that lifestyle modifications aren't sufficient enough to control type 2 diabetes in the long term. Type 2 diabetes is a progressive disorder and, over time, we see further changes in biology that make it more difficult to control."
Ratner noted that lifestyle changes don't bring diabetes under control for everyone. "We emphasize the importance of lifestyle modifications in all forms of diabetes, but the fact that diabetes sometimes remains uncontrolled is biology, and not something that is the patient's fault," he said.
Still, both Ratner and Gregg said, spending extra years with good blood sugar control, as many of the participants in this study did, would likely help to prevent complications. Ratner said these programs tend to be cost effective when the reduction in diabetes complications, as well as improved overall health and a reduced need for other medications such as high blood pressure or high cholesterol drugs, are taken into account.
Learn more about type 2 diabetes from the American Diabetes Association.
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