Nearly one in 20 people with type 2 diabetes experienced remission of the condition — normal blood glucose for at least two months, without taking any glucose-lowering medications — according to a new study published in the journal PLOS Medicine.
Just how achievable diabetes remission is, and how to achieve it, have been hot topics in the diabetes community in recent years. One treatment that has been closely linked to diabetes remission is bariatric (weight-loss) surgery, also called metabolic surgery in the context of diabetes. While this surgery has even been hailed as a potential diabetes “cure” for many people, not everyone with type 2 diabetes is eligible for the surgery — and even those who are eligible may have concerns about the risks involved. Other strategies that may help promote diabetes remission include following a low-carb diet and losing 10% of more of your body weight if you’re overweight or obese, especially within the first five years of a diabetes diagnosis. But the data on non-surgical strategies for achieving diabetes remission is lacking.
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For the latest study, researchers in Scotland assessed the prevalence of type 2 diabetes remission in the country among adults at least 30 years old during the calendar year 2019. They defined remission as an A1C level (a measure of long-term blood glucose control) below 6.5% without taking any glucose-lowering medications for at least a year before the last recorded A1C level in 2019. The study participants were 162,316 people who all had a recorded A1C level of at least 6.5% after a documented diabetes diagnosis. Most participants (56%) were at least 65 years old in 2019, and 64% had type 2 diabetes for at least six years. Participants were overwhelmingly white (74%), with data on race or ethnicity not available for 19% of the group. The median body-mass index (BMI, a measure of body weight that takes height into account) of participants at the time of diabetes diagnosis was 32.3, which falls in the category of “obese.”
Diabetes remission more common than suspected
The researchers found that 7,710 participants, or 4.8%, experienced diabetes remission in 2019. Factors that made people more likely to experience remission included older age — those at least 75 years old were 48% more likely to experience remission than those ages 45 to 54. Other factors that increased the likelihood of remission included having no history of taking glucose-lowering medications — this group was 14.6 times as likely to experience remission — and losing at least 15 kilograms (33 pounds) of body weight between diabetes diagnosis and 2019, compared with no weight loss or weight gain — this group was 4.45 times as likely to achieve remission. People who underwent bariatric surgery were 11.9 times as likely to experience diabetes remission as those who didn’t have the surgery.
The researchers noted that diabetes remission appears to be more common than was previously suspected. “Guidelines are required for management and follow-up of this group,” they concluded, “and may differ depending on whether weight loss and remission of diabetes were intentional or unintentional.” In any case, they wrote, these findings may help guide future studies on the prevalence of diabetes remission and the characteristics of people who experience it.
Want to learn more about type 2 diabetes remission? Read “Type 2 Diabetes Remission — Can It Be Done?” and “Diabetes ‘Remission’ Is Best Term for Glucose Levels, Report Says.”