Can Diabetes Be 'Cured'? Or Can It Only Be 'Managed'?

Okay, no problem. Let's talk about this concern many people have in plain language.

Hey friend, let's talk plainly about "cure" versus "control" for diabetes.

This is a really great question and the biggest doubt in the mind of everyone who's just found out they have diabetes.

Overall, for the vast majority of diabetes buddies (a nickname for people with diabetes), the more accurate term right now is "effective control," not "complete cure."

But here's some good news: For some people with type 2 diabetes, through hard work, it's possible to achieve a state called "remission," which is very close to what we ordinary folks understand as "being cured."

Let me break this down for you.

Why can't it be "cured" like a cold?

To understand this, we need a quick look at what diabetes actually is. Our bodies have something called "insulin," which acts like a delivery person, responsible for transporting sugar (energy) from the blood into the body's cells. Diabetes is when this "delivery system" breaks down.

Type 1 Diabetes: This is like the "factory" in your body that produces insulin (the beta cells in the pancreas) being destroyed by your own immune system. With the factory gone, you have to get supplies from outside (insulin injections). This is lifelong, and currently, we can't rebuild the factory. So type 1 diabetes can only be "controlled."
Type 2 Diabetes: This is the most common type. It's a bit more complex. It could be:
1. The factory is still there, but the "workers" are slacking off, and production can't keep up (insulin secretion is insufficient).
2. The delivery arrives (insulin), but the "cells" receiving it won't open the door or respond (this is called "insulin resistance"). Most people with type 2 diabetes have a combination of both issues. Because the factory (pancreas) is weakened, or the cells' "bad habit" (resistance) is ingrained, it's hard to talk about a "complete cure."

What is "remission"? How is it different from a "cure"?

This is the most hopeful part, especially for many people with type 2 diabetes!

"Remission" means that without using any diabetes medication, your blood sugar levels stay consistently within the normal or near-normal range (usually HbA1c <6.5%) for at least 3 months or more. Doesn't that sound like you're "cured"?
The difference from a "cure" is that this "being cured" is conditional. The "root" of diabetes – meaning your body's underlying tendency towards insulin resistance or insufficient secretion, this inherent "constitution" – is still there.

I like to explain it with a garden analogy:

Your body is like a garden that's particularly prone to weeds (high blood sugar).

"Control" is like regularly weeding, fertilizing, and watering (using medication, controlling diet, exercising) to keep the garden looking neat and tidy, with flowers blooming well.

"Remission" is like doing a thorough cleanup (e.g., significant weight loss), removing all the weeds so the garden looks exactly like those gardens that naturally don't grow weeds. But if you stop managing it completely, the weed seeds are still in the soil, and they will slowly grow back.

A "cure" would be like replacing all the soil in this land so it never grows weeds again. Current technology can't do this.

So, who is more likely to achieve "remission"?

Achieving "remission" isn't a pipe dream, but it does require tremendous effort, and it's easier for some people:

People with short-duration type 2 diabetes: For example, if you were diagnosed just a year or two ago, your insulin "factory" isn't as exhausted yet, and its function is still preserved.
Patients who are overweight or obese: Because obesity is the main culprit behind the problem of "insulin resistance." Losing weight, especially visceral fat, makes it easier for the cells' "doors" to open.
People with strong determination and perseverance: The main way to achieve remission is through intensive lifestyle intervention, with the core being weight loss! This includes strict dietary control (like very low-carb or very low-calorie diets, which should be done under medical supervision) and significant exercise. For some severely obese individuals, even metabolic (bariatric) surgery can achieve it.

For most people, "effective control" is victory!

Even if you can't achieve "remission," don't get discouraged! "Effective control" itself is a huge success.

Remember the "Five Carriages" of diabetes management – this is the consensus in our diabetes community:

Medical Nutrition Therapy (Diet): Learn to eat, and eat right.
Exercise Therapy: Get moving, stay active.
Medication: Use medication scientifically as a helpful tool for your body.
Blood Glucose Monitoring: Understand your body, know where you stand.
Diabetes Education: Learn the facts, don't be an uninformed patient.

The goal of "control" isn't to make you feel like a patient. On the contrary, it's to allow you to enjoy life like a healthy person – to travel, to enjoy good food (in moderation, of course), to pursue your dreams – while avoiding or delaying terrible complications (like eye disease, kidney disease, foot problems, etc.).

To summarize

"Cure" is difficult: Medically speaking, diabetes currently cannot be completely eradicated.
"Remission" is possible: For some people with type 2 diabetes, especially those diagnosed early or who are obese, achieving normal blood sugar without medication is possible through immense effort.
"Control" is key: For all diabetes buddies, using the "Five Carriages" to manage blood sugar well, prevent complications, and enjoy a high quality of life – this is the ultimate goal and victory we strive for.

So, don't get too hung up on the word "cure." Focus on "management" and "control." You are the master of your own health. Keep going!