The aim of diabetes treatment is to reach a state of “post-diabetes”, aka remission.

It’s important to understand that the purpose of the process isn’t to go back to a pristine body that has never been exposed to diabetes. It’s most likely impossible since damage has been done during diabetes onset. For example, it’s not clear whether muscle insulin resistance can be completely reversed. But it doesn’t seem to be determinant in the natural history of T2DM.

Post-diabetes refers to a state of the body where it behaves functionally like a non-diabetic body, no matter what it’s been through historically.

In some people, that state shows HbA1c < 5.6%, i.e. no trace of diabetes and below pre-diabetes levels. For others, especially when treatment was started a long time after diabetes onset, blood glucose can’t go back to normal. But for most people it can go below 6.5%, i.e. below diabetes. However, even between 5.6% and 6.5%, post-diabetes behaves differently than during normal pre-diabetes, and according to Dr Taylor doesn’t have the associated health side-effects.

Note that unlike for some other diseases, e.g. cancer, remission doesn’t imply that the disease can come back out of the blue according to researchers. Diabetes remission is considered permanent with the caveat that no significant weight loss takes place.