Type 2 Diabetes Remission Can Happen Naturally in 1 in 20
Clinical pathways are changing to incorporate support and appropriate follow-up for people to achieve remission of type 2 diabetes, but there is limited understanding of the prevalence of remission in current practice or patient characteristics associated with remission.

Researchers carried out a cross-sectional study estimating the prevalence of remission of type 2 diabetes in all adults in Scotland aged more than 30 years diagnosed with type 2 diabetes. They defined remission as all HbA1c values less than 48 mmol/mol in the absence of glucose-lowering therapy (GLT) for a continuous duration of more than 365 days before the date of the last recorded HbA1c in 2019.

The cohort consisted of 162,316 individuals, all of whom had at least 1 HbA1c more than 48 mmol/mol (6.5%) at or after diagnosis of diabetes and at least 1 HbA1c recorded in 2019 (78.5% of the eligible population). Over half (56%) of cohort was aged 65 years or over in 2019, and 64% had had type 2 diabetes for at least 6 years.

The cohort was predominantly of white ethnicity (74%), and ethnicity data were missing for 19% of the cohort. Median body mass index (BMI) at diagnosis was 32.3 kg/m2. A total of 7,710 people were in remission of type 2 diabetes. Factors associated with remission were older age for people aged more than 75 years compared to 45 to 54 year group), HbA1c less than 48 mmol/mol at diagnosis compared to 48 to 52 mmol/mol), no previous history of GLT, weight loss from diagnosis to 2019 for more than 15 kg of weight loss compared to 0 to 4.9 kg weight gain), and previous bariatric surgery.

In this study, it was found that 4.8% of people with type 2 diabetes who had at least 1 HbA1c more than 48 mmol/mol (6.5%) after diagnosis of diabetes and had at least 1 HbA1c recorded in 2019 had evidence of type 2 diabetes remission. Guidelines are required for management and follow-up of this group and may differ depending on whether weight loss and remission of diabetes were intentional or unintentional. Our findings can be used to evaluate the impact of future initiatives on the prevalence of type 2 diabetes remission.

Source: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003828
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