I'm not at all sure that anyone's managed to define an optimised
version of weight, exercise and / or diet... that's why, for diabetes
control, PP and A1c testing are the best measures we have.

Also, I'm not at all convinced there is such a thing as "a significant
level of irreversible natural progression", or that your A1c would
necessarily indicate it. I think that many diabetic complications are
at least partially reversible, even after many years of high readings,
IF you can exercise good control now.

So the real question is - what do you need to do to get your bg
control back into range? Where are you starting from?

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6%  BMI 25

I don't know the answer to your question ... but I do know that I was
diagnosed as T2 about 3 years ago with an HbA1c of 9.0.  The doctor
agreed to give me 90 days to try to bring my blood sugar under control
with diet, since I really fought being put on chemicals.  To make a
long short, my a1c had dropped to 6.0 in that 90 days, and on my most
recent blood test last month it was 5.1.   I completely avoid sugar
and simple starches, and have switched to only "healthy" fats.  It's
not as hard as it sounds; I love what I'm eating.  Tonight for
instance, I ate grilled scallops, sweet potato and a pile of boiled
seasoned mixed  greens (collard, kale and turnip)  for dinner.  Yum!
Low fat and low carb, low calorie with  tons of vitamins and
nutrients, and no insulin spike -- and I feel satisfied.  My beta
cells are smiling!

Long-term control of type 2 diabetes mellitus and the other major
components of the metabolic syndrome after biliopancreatic diversion
in patients with BMI < 35 kg/m2.Scopinaro N, Papadia F, Marinari G,
Camerini G, Adami G.
University of Genoa Medical School, Azienda Ospedaliera Universitaria
San Martino, Department of Surgery, Genoa, Italy. scopinar@unige.it

Obes Surg. 2007 Feb;17(2):185-92

BACKGROUND: Bariatric operations are the most powerful means of curing
type 2 diabetes mellitus (T2D) and the other major components of the
metabolic syndrome. Despite the very frequent occurrence of metabolic
disturbances in patients with BMI from 30 to 35, there is a general
reluctance to operate on these patients, as their disease is
considered less severe. METHODS: 7 T2D obese patients with mean BMI <
35 underwent BPD between 1976 and 1996 at the Azienda Ospedaliera
Universitaria San Martino of Genoa, Italy. Mean age was 49 years, mean
body weight 91 kg, and mean waist circumference 115 (M) and 98 (F) cm.
The mean follow-up was 13 (10-18) years. All 7 patients had abnormally
high values of serum triglyceride, serum cholesterol, and arterial
pressure. RESULTS: In all patients, serum glucose was normalized at
1,2, and 3 years. In 5 patients, a slight increase of serum glucose
above 125 mg/dl was observed at or around 5 years, the values being
maintained at all subsequent times, with no one value higher than 160
mg ever being recorded. The other 2 patients showed full resolution of
diabetes at all follow-up times. Both serum cholesterol and
triglyceride values fell to normal 1 year after BPD, and remained
within the normal range in all 7 patients during the entire follow-up
observation. Arterial pressure normalized in 6 cases and was improved
in 1 case. No patient had excessive weight loss at any postoperative
time. CONCLUSIONS: T2D patients with BMI < 35 have very severe
metabolic disturbances. Surgical therapy for these patients is
warranted, and it should be performed as soon as possible, before the
rapid evolution of the pattern leads them to a point where even the
most effective metabolic surgery operation could be insufficient to
yield complete and permanent control of their diabetes.

** end abstract **

Where type-2 diabetes is cured, there is no further progression.

This does happen when the VAT (visceral adipose tissue) is lost by
eating less, down to the optimal amount, either when forced to do so
by either bariatric surgery or circumstance or...

... by willful choice via the non-surgical equivalent to bariatric
surgery:

http://HeartMDPhD.com/EatLess

Illustrative case example:

http://HeartMDPhD.com/HolySpirit/Healing

This completely free Approach comes with free cardiologist support via
usenet plus an unprecedented two-million dollar guarantee whose
details have been freely posted and discussed in sci.med.cardiology as
archived in Google:

http://HeartMDPhD.com/Guarantee

Be hungry... be healthy... be hungrier... be blessed:

http://TheWellnessFoundation.com/BeHealthy

Prayerfully in the infinite power and might of the Holy Spirit,

Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Bondservant to the KING of kings and LORD of lords.