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FAQ

Q: Can Type 2 diabetes be reversed?

A: Diabetes remission is quite a new idea. Some people call this ‘reversing Type 2 diabetes’, but the term remission is preferred. This is because a lot of research is needed before it can be fully understood as there is not enough evidence that remission is permanent. It needs to be maintained and, in many cases, diabetes can come back, which is why it is so important to continue your diabetes appointments while in remission. The definition of diabetes remission has been agreed by a team of international experts from Diabetes UK, the American Diabetes Association, and the European Association for the Study of Diabetes. If your regular blood tests show your HbA1c remaining below 48 mmol/mol or 6.5%, talk to your healthcare team to discuss diabetes remission and how this applies to you.

The strongest evidence currently suggests that diabetes is mainly put into remission by weight loss (https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/whats-your-healthy-weight/lose-weight).

If you have obesity, you are more likely to put your diabetes into remission if you lose a substantial

amount of weight – 15kg (or 2 stone 5lbs) – as quickly and safely as possible following your diagnosis. If you do want to start losing weight quickly to work towards remission, it’s important to talk to a healthcare professional before you begin, to make sure it’s right for you.

Q: Why am I losing weight but have been diagnosed with Type 2 diabetes?
A: Weight loss with no obvious cause can happen to people with Type 2 diabetes, but it’s more commonly found in people with Type 1 diabetes. It usually occurs because the body starts to burn fat rather than glucose, causing a reduction in body weight.
Q: I’m not overweight so why do I have Type 2 diabetes?
A: You don’t have to be overweight to have Type 2 diabetes. Your body may not make enough insulin, or you may not respond to insulin as well as you should. You may store fat around your organs rather than under the skin, which could impact insulin production and bodily response. Your diet may also be high in sugar and unhealthy fats, which could play a role in you having developed Type 2 diabetes.
Q: Why does Metformin need to be taken with food?
A: It’s best to take Metformin with a meal to reduce the side effects, as the most common side effects can be feeling and/or being sick, diarrhoea, stomach-ache, and loss of appetite
Q: Can I stop taking my metformin if my blood sugar levels improve?
A: You may be able to stop taking it if your doctor thinks you can maintain your blood sugar without it. You may be able to successfully lower and manage your blood sugar without medication by making lifestyle changes such as the following: maintaining a healthy weight and doing more exercise. It is important to stress this should only be stopped on the advice of a healthcare professional.
Q: What happens if I forget to take my medication? Do I resume as normal or take it as soon as I remember?
A: If you miss a dose of Metformin, take the next dose at the usual time. Do not take a double dose to make up for a forgotten dose. If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
Q: Why haven’t I been given a monitor to test my levels daily?
A: Not everyone with diabetes needs to check their sugar levels. You’ll only need to do it if you take certain diabetes medication. Always talk to your healthcare team if you’re not sure whether that is you – they’ll give you advice on whether you need to check them yourself and if so, how often.
Q: Do I no longer have diabetes if my blood sugar levels return to within the normal range?
A: People with Type 2 diabetes can put their diabetes into remission, this means that your blood sugar levels are healthy without needing to take any diabetes medication. It is a very new concept, and a lot of research still needs to be made into the effectiveness of diabetes remission and if it is permanent. It is always best practice to speak to your healthcare professional and continue with your appointments.
Q: I have swapped sugar for artificial sweetener is that ok?
A: It’s a personal choice whether you decide to use sweeteners or not. If you decide to use sweeteners, but you’re unsure, speak to your diabetes healthcare team for individual advice, and check labels and ingredients on food packaging, as this can help you to make informed choices.
Q: I have heard that bananas are bad for me as they contain a lot of sugar should I stop having them completely?
A: People sometimes think that, if they have diabetes, they can’t eat grapes and bananas as they taste sweet. But if you eat a diet that includes these fruits, you can still achieve good blood glucose control. In fact, grapes, and bananas, like all fruit, make a very healthy choice. Ripe bananas have a Glycaemic Index (GI) of 51, which is considered low (a GI of 55 or lower means that the food will not significantly raise blood sugars). And a slightly unripe banana has a GI of 42, which is even lower. (You might want to limit eating overripe bananas, however, as they have a higher GI of around 62).
Q: I have been told that I need to cut out white rice, pasta & white bread completely from my diet, is that true?
A: It is advised to opt for brown grains or wheats over white. For example, brown rice has a big advantage over white rice when it comes to nutrient content. Brown rice has more fibre and antioxidants, as well as a lot more important vitamins and minerals. Not only do wholegrains contain a more nutritious value, but they are also lower foods on the GI index. However, we would never advocate cutting these out of your diet completely, especially if brown or whole grains are not an option. Everything is ok in moderation.
Q: I don’t eat meat so where can I get my protein from?

A: You don’t need to eat meat to have a protein rich diet, below are some examples of what you can eat as a meat alternative:

• Pulses. Pulses are an inexpensive protein choice, are high in fibre and a source of iron.

• Soya beans. Unlike other pulses, soya beans are a complete protein, comparable in quality with animal protein, but are low in fat and contain fibre and iron.

• Quinoa

• Nuts

• Seeds

• Cereals and grains

• Quorn

• Dairy

• Lentils

• Chickpeas

Q: Is Greek yogurt better than any other yogurt?
A: Regular and Greek yoghurt are made from the same ingredients but differ in nutrients. While regular yoghurt tends to have fewer calories and more calcium, Greek yoghurt has more protein and less sugar. Try and always opt for a low fat, natural plain yoghurt and use your own fruits to make it naturally sweeter.
Q: Eggs are high in cholesterol - should I stop eating them?
A: Eggs are a good choice as part of a healthy, balanced diet. As well as being a source of protein, they also contain vitamins and minerals, and although eggs contain some cholesterol, the amount of saturated fat we eat has more of an effect on the amount of cholesterol in our blood than the cholesterol we get from eating eggs.
Q: What are examples of healthy snack substitutes for Type 2 diabetics when on the go?
A: You could choose a snack such as: a piece of fruit, a 14g mini box of raisins, 1 rice cake, 10 almonds, 4 breadsticks, 15g pot of sugar-free jelly, hardboiled egg, 25g root veg crisps or 30g ready-to-eat partially rehydrated prunes.
Q: Are sugar substitutes such as artificial or natural sweeteners safe?

A: A major question that often comes up is how safe sweeteners are. There has been, and continues to be, some bad publicity and controversies about certain artificial sweeteners.

Both Cancer Research UK and the US National Cancer Institute have said sweeteners do not cause cancer. “Large studies looking at people have now provided strong evidence that artificial sweeteners are safe for humans,” states Cancer Research UK.

All non-nutritive sweeteners used in foods in the EU must undergo rigorous safety testing before being approved by the European Commission. Food ingredient manufacturers must provide evidence from safety studies showing that the sweetener in question:

• doesn’t cause any adverse effects, including cancer

• doesn’t affect reproduction

• doesn’t cause allergic reactions

• isn’t stored within the body or metabolised into other potentially unsafe products.

If you are unsure what is suitable for you, speak with your healthcare professional to obtain some advice.

Q: Is honey a better alternative to sugar?

A: Generally, there’s no advantage to substituting honey for sugar in a diabetes eating plan. Both honey and sugar will affect your blood sugar level.

Honey is sweeter than granulated sugar, so you might use a smaller amount of honey for sugar in some recipes. But honey actually has slightly more carbohydrates and more calories per teaspoon than does granulated sugar - so any calories and carbohydrates you save will be minimal.

Q: As someone with Type 2 diabetes, do I turn into a Type 1 diabetic when I take insulin?
A: No. Taking insulin does not mean that you have Type 1 diabetes. Your type of diabetes is determined by your genetics, not by the type of therapy.
Q: Will I need to take insulin if I have Type 2 diabetes?
A: Maybe. Historically, 30% or more of people with Type 2 diabetes required insulin therapy. However, there are many new drugs available that may delay or prevent the need for insulin therapy. It is expected that fewer and fewer individuals will need insulin replacement to control their blood sugars.
Q: Should I eat foods labelled as ‘diabetic’?
A: Although foods are labelled as ‘diabetic’ they tend to still be high in fat, especially saturated fat, and calories. Some even contain the same amount of sugar as a ‘nondiabetic’ food. Diabetes UK states that it is not recommended to eat ‘diabetic’ foods, including diabetic chocolate, as they can still affect your blood glucose levels, they are expensive, and they can give you diarrhoea.
Q: Can I still drive if I have diabetes?
A: If you are responsible and maintain a good control of your diabetes, research has shown that people with diabetes are no less safe on the roads than anyone else. You should always check with your doctor or healthcare professional if your medication can affect your blood glucose levels, as not only will you need to check them regularly before and during your journey, but you may also need to alert the DVLA.
Q: I have heard I cannot eat bananas, mangoes, or grapes. Is this true?
A: People sometimes think that if they have diabetes, they can’t eat grapes, mangoes, and bananas as they taste sweet. But if you eat a diet that includes these fruits, you can still achieve good blood glucose control. Just be sure to spread your fruit intake throughout the day and have a healthy balanced diet full of vegetables and leafy greens!
Q: Can I still travel with my diabetes?
A: Of course, you can! Having diabetes doesn’t mean you can’t take that trip, but you just need to ensure you make the right preparations to minimise any potential problems. This could include ensuring you have enough medication with you in case of delays, and always keeping it in your hand luggage whilst travelling; wearing sunglasses that have a UV400 label to make sure they protect your eyes; and taking particular care of your feet if you have neuropathy, as you may not be aware if your skin is burning.
Q: Does having diabetes limit my choices for employment?
A: Having diabetes should not stop you from getting and keeping a job. However, despite the Equality Act 2010 (Disability Discrimination Act in Northern Ireland), people with diabetes still face blanket bans in some areas of employment, including the armed forces. Campaigns are still ongoing to have these blanket bans removed.