diabetes that comes and goes

Overview

Diabetes is a condition where blood sugar levels are too high. For most people, diabetes is a lifelong condition, but sometimes it may seem like diabetes comes and goes. This can happen when blood sugar levels return to normal for a while, such as when someone with type 2 diabetes makes major lifestyle changes and goes into remission, or when a person has gestational diabetes during pregnancy that later goes away. Even when blood sugar levels are normal, the underlying tendency to have diabetes may still be there, so it is important to keep monitoring and stay in touch with your healthcare provider.

It is common for blood sugar levels to vary from day to day, but true remissions that last for many months are less common. When they do happen, it is often linked to significant weight loss or other lifestyle changes.

Diabetes that seems to come and go can affect people with type 2 diabetes who have changed their diet and exercise habits, women who had gestational diabetes, and people who have high blood sugar due to a temporary cause, such as certain medications or illnesses.

Symptoms

Common symptoms

• Feeling more thirsty than usual
• Urinating more often
• Feeling very tired
• Blurred vision
• Slow healing of cuts and bruises

Symptoms in children

• Sudden bedwetting or needing the toilet often
• Weight loss even when eating enough
• Very low energy or crankiness
• Sweet-smelling breath or fruity breath

Symptoms in older adults

• Feeling confused or more forgetful than usual
• Dizziness when standing up
• Dry, itchy skin
• Repeated infections, such as bladder or skin infections

Causes

Main causes

• Type 2 diabetes can go into remission when the body becomes more sensitive to insulin again, often after weight loss or major lifestyle changes.
• Gestational diabetes can appear during pregnancy and usually goes away after delivery, but it may return in future pregnancies or later in life.
• Temporary high blood sugar can be triggered by an illness, stress, or certain medications, and may resolve once the cause is treated.

Risk factors

• Having a family history of diabetes
• Being overweight or having obesity
• Being over 40 years old (or over 25 if you are from certain ethnic backgrounds)
• Having had gestational diabetes in a previous pregnancy
• Living a sedentary lifestyle with little physical activity
• Having high blood pressure or high cholesterol

When to see a doctor

See a doctor urgently if:

• If you have any symptoms of very high blood sugar, such as extreme thirst, frequent urination, or nausea, see a doctor the same day.
• If you have symptoms of very low blood sugar, such as trembling, sweating, or feeling faint, treat it immediately and get medical advice.
• If you are pregnant and you notice diabetes symptoms, contact your maternity team without delay.

Book a routine appointment if:

• If you have been told you have prediabetes or high blood sugar before, ask your doctor for a repeat test.
• If you have had gestational diabetes, have your blood sugar checked at your 6-week postnatal checkup and again every 1 to 3 years.
• If you are checking your blood sugar at home and notice a pattern of high levels, make an appointment to discuss it.

Diagnosis

Diabetes is diagnosed with a blood test that measures your blood sugar level. If your blood sugar is high at one visit and normal at another, your doctor may order more tests to see whether your diabetes is truly gone or if it is still there in a milder form.

Tests that may be done

• Fasting blood sugar test: a blood sample taken after you have not eaten for at least 8 hours.
• HbA1c test: a blood test that shows your average blood sugar level over the past 2 to 3 months.
• Oral glucose tolerance test: after drinking a sugary drink, your blood sugar is measured at intervals to see how your body handles it.

What to expect at your appointment

Your doctor will likely ask about your symptoms, medical history, and any medicines you take. The tests are quick and simple. If your blood sugar is normal at first but your risk of diabetes is high, your doctor may suggest repeating the test regularly to catch any changes early.

Treatment

If diabetes seems to come and go, treatment focuses on keeping blood sugar levels in a healthy range during the times they are high, and preventing them from dipping too low when they are normal. Your doctor will help you create a plan that changes as your blood sugar changes.

Self-care at home

• Check your blood sugar as often as your doctor suggests, and keep a record of the numbers.
• Take any prescribed diabetes medications exactly as directed, even when you feel fine.
• Learn to recognize the early symptoms of high and low blood sugar.
• Carry a sweet snack with you in case your blood sugar drops suddenly.

Medical treatments

Some people need medications to bring their blood sugar down, and some may need insulin for a period of time. If your blood sugar returns to normal, your doctor may reduce or even stop your diabetes medications. Never stop or change your medication on your own. Your doctor might also recommend regular eye, kidney, and foot checks to make sure your diabetes has not caused hidden problems.

When is surgery considered?

For some people with type 2 diabetes and obesity, weight-loss (bariatric) surgery can help put diabetes into remission. This is not a first-line treatment and is only considered after trying other weight-loss methods. You and your doctor can discuss whether this might be an option for you.

Living with this condition

Living with blood sugar levels that sometimes go high and sometimes normal can feel confusing. The best way to manage it is to keep a simple routine: eat balanced meals, move your body regularly, take your medications as prescribed, and go to your follow-up appointments. Write down any questions you have and bring them to your next visit.

Lifestyle tips

• Aim for at least 30 minutes of moderate activity, like brisk walking, on most days.
• Try to get 7 to 8 hours of sleep at night to help your body use insulin better.
• Manage stress with relaxation techniques like deep breathing, meditation, or talking to a friend.
• If you smoke, consider stopping – smoking makes blood sugar harder to control.

Diet and exercise

Eating a balanced diet rich in vegetables, whole grains, lean proteins, and healthy fats can help keep your blood sugar steady. Try not to skip meals, and be consistent with the amount of carbohydrates you eat. Regular physical activity helps your body use insulin more effectively and can lower blood sugar for hours after you finish.

Mental health and emotional wellbeing

Having diabetes that comes and goes can feel frustrating and worrying, especially when you work so hard to keep your blood sugar normal. It is completely understandable to feel anxious or discouraged. If you notice that these feelings affect your daily life, talk to your healthcare team – they can support you and connect you with counselling or diabetes support groups.

Prevention

Type 2 diabetes can often be prevented or delayed by maintaining a healthy weight, eating a balanced diet, and staying physically active. If you have already had high blood sugar, these same habits can also help you avoid diabetes from coming back.

Vaccines

People with diabetes, even if it is only present some of the time, have a higher risk of severe infections. It is a good idea to stay up to date with routine vaccines, such as the flu vaccine and the COVID-19 vaccine. Talk to your pharmacist or healthcare provider about which vaccines are recommended for you.

Screening programmes

If you have had gestational diabetes or prediabetes before, ask your doctor how often you should have your blood sugar checked. Regular screening can help you catch any rise in blood sugar early, when lifestyle changes are most likely to help.

Complications

If left untreated

• If high blood sugar is left untreated even temporarily, it can damage blood vessels over time.
• It can increase the risk of heart disease, stroke, and kidney disease.
• It may cause nerve damage, leading to numbness, tingling, or pain in the hands and feet.
• It can damage the small blood vessels in the eyes, leading to vision problems.

Long-term outlook

Many people with diabetes that seems to come and go live full and healthy lives. By staying alert, keeping regular appointments, and taking care of your body, you can keep complications unlikely. Even if diabetes comes back, early treatment makes a huge difference. Your healthcare team will work with you every step of the way.

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