by Bonny C Damocles
PERSONAL EXPERIENCE:
By Bonny C. Damocles
I am 80 years old and have lived with type 2 diabetes for almost 25 years. My diagnosis followed a fasting glucose of 468 mg/dL. After passing a stress test, my doctor allowed me to use exercise instead of diabetes tablets. I now exercise for at least 100 minutes daily using stair climbing, power walking, modified push-ups and jogging in place. I eat two meals daily without snacks, although many of my favorite foods are carbohydrates. My HbA1c results were 6.3% in October 2014, 5.6% in May 2015 and 6.0% in October 2015. I take no prescription medicines, have not experienced hypoglycemia and feel healthy. I hope to remain active and free of complications as I grow older.
Quick Answer
HbA1c results of 5.6%–6.3% without glucose-lowering medicine are excellent. If HbA1c remains below 6.5% for at least three months without diabetes medicine, this may meet the modern definition of type 2 diabetes remission. Remission is not a cure, and continued eye, kidney, foot, cardiovascular and laboratory monitoring is still necessary. Your active lifestyle may be contributing greatly, but two meals a day, a carbohydrate-heavy diet and 100 minutes of exercise daily are not automatically appropriate for every older adult.
Response by Dr. Albana Greca, MD, MMedSc
Hello Bonny,
Your long-term activity and HbA1c results are impressive. Your experience can encourage others, but it is one individual outcome rather than a plan everyone should copy.
An HbA1c below 6.5% for at least three months without glucose-lowering medicine can meet the current definition of type 2 diabetes remission. Based on the results you reported, remission is possible if you truly used no diabetes medicine during that period and the HbA1c tests were reliable.
Remission does not erase the diagnosis or guarantee normal glucose permanently. Diabetes can return with illness, weight change, reduced activity, aging or beta-cell decline. Continue HbA1c checks as advised. See our HbA1c guide.
HbA1c can sometimes be misleading in people with anemia, kidney disease, recent blood loss or transfusion, or certain hemoglobin variants. If home readings do not match the HbA1c, your clinician may compare it with laboratory glucose, structured meter readings or continuous glucose monitoring.
A fasting glucose of 468 mg/dL is severe hyperglycemia and strongly supports a diabetes diagnosis when the result is accurate. A similar reading today would require urgent medical assessment, particularly with excessive thirst, frequent urination, weakness, dehydration, vomiting, confusion or drowsiness.
Good results years later do not mean the original diabetes was imaginary. They show that glucose regulation has improved substantially. See our guidance on dangerous blood sugar levels.
Exercise helps muscles use glucose, improves insulin sensitivity and supports cardiovascular health, strength and independence. It does not work by flushing harmful metabolites from the cells or supplying “oxygenated water.”
One hundred minutes every day equals about 700 minutes weekly, far above the usual minimum recommendation for most adults. At age 80, exercise should include aerobic activity, strength, flexibility and balance, with enough recovery. A stress test performed decades ago does not confirm that the same intensity remains safe today.
Ask your clinician to review your current heart health, blood pressure, joints, feet, vision and fall risk. Stop exercising and seek medical advice for chest pressure, faintness, a new irregular heartbeat, unusual breathlessness, severe weakness or persistent pain. Our diabetes and exercise guide explains safe planning.
Important: Do not increase exercise simply to compensate for a high-carbohydrate meal. Activity is valuable, but excessive training can cause injury, dehydration, loss of muscle or cardiovascular strain in susceptible older adults.
Two meals daily may suit some people, but it is not inherently better than three meals. Meal frequency should support adequate nutrition, stable energy, healthy weight and personal glucose goals.
At age 80, preserving muscle is especially important. Two large meals may limit protein distribution and produce larger glucose rises. A dietitian can review calories, protein, calcium, vitamin D, fiber and fluids.
Snacks are not mandatory when meals provide adequate nutrition and you are not using medicine that causes hypoglycemia. However, avoiding snacks is not a special diabetes treatment, and a planned snack may be appropriate for some people.
Yes. Carbohydrates differ in quality and portion size. Legumes, vegetables, whole grains and whole fruit provide fiber and nutrients, while sugary drinks, refined grains and large portions may raise glucose quickly.
Good HbA1c does not prove that every high-carbohydrate meal is harmless. Consider occasional one- or two-hour after-meal checks to identify large spikes, especially when the meal is rich in refined starch. Our guide to carbohydrates and diabetes explains portion, fiber and glucose response.
Avoiding unnecessary medicine is reasonable, but needing medicine is not a failure. If glucose rises or heart, kidney or other risks change, treatment may become beneficial even with an excellent lifestyle. Modern diabetes medicines may be selected for cardiovascular or kidney protection in some patients, not only to lower HbA1c.
Never delay appropriate treatment to preserve the label of being “drug-free.” The best plan is the safest one that supports healthy glucose, function and quality of life. Review current options in our type 2 diabetes treatment guide.
Eye, kidney, nerve and artery disease may develop without symptoms. After 25 years, preventive care remains essential even during remission.
Learn more in our overview of diabetes complications and prevention.
Bonny, your results deserve recognition. The safest lesson is that sustained activity, suitable nutrition, individualized treatment and regular screening can support a long, active life.
This educational response does not replace individualized exercise, nutrition or diabetes follow-up from your healthcare professional.
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