In his Guest Editorial “How to help patients become successful diabetes self-managers” (J Fam Pract. 2020;69:8-9), Dr. Unger makes several very good points. I especially liked his recommendation to ask patients why they are concerned about having diabetes; this question alone can kick-start the behavior modification process leading to improved diabetes control.
However, I disagree with Dr. Unger’s assertion that “diabetes cannot be cured.” Based on multiple case studies, clinical trials, results from lifestyle intervention programs, and my own experience as a family physician, it is clear that diabetes can be reversed with lifestyle changes designed to counteract the modifiable factors (eg, diet, lack of exercise) that usually cause this condition.
Rather than merely considering the diabetes measure of success to be blood glucose controlled by prescribed medication, it is important to offer a more collaborative approach to patients willing to make lifestyle changes. We can show many—if not most— that they can achieve the goal of blood glucose control without medication.
Allan Olson MD
Diplomate, American Board of Family Medicine and American Board of Lifestyle Medicine
Kewaunee, WI