Can Sustained Weight Loss Lead to Remission of T2D?

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Two tests administered 2 months apart, with results below the diagnostic threshold for T2D, can confirm diabetes remission.
Two tests administered 2 months apart, with results below the diagnostic threshold for T2D, can confirm diabetes remission.

HealthDay News — For many patients with type 2 diabetes, remission can be achieved with sustained weight loss of roughly 15 kg, yet this often flies under the radar for patients and clinicians alike, according to an analysis published online in The BMJ.

Noting that type 2 diabetes affects 5% to 10% of the UK population, and is associated with greater medical costs, Louise McCombie, RD, from the University of Glasgow in the United Kingdom, and colleagues discuss the importance of achieving remission of type 2 diabetes.

The researchers note that the primary aim of management is lowering blood glucose or HbA1c concentrations. Weight loss is associated with extended life expectancy, and weight loss of about 15 kg can induce total biochemical remission. There is currently no consensus on the criteria for diabetes remission; measurement of either HbA1c or blood glucose is sufficient to determine remission. Two test results (usually HbA1c) below the diagnostic threshold, at least 2 months apart, can confirm remission. Patients in remission should be monitored regularly with annual testing. Although no study has reported outcomes for those who achieve remission, good glycemic control is associated with improved microvascular outcomes. Patients are rarely recorded as being in remission, possibly because few patients are attempting or achieving remission.

"It is in everybody's interest to reclassify people with type 2 diabetes when they become non-diabetic," the authors write. "Official guidelines and international consensus for recording diabetes in remission are needed."

Disclosures: Two authors provide consultancy to Counterweight.

Reference

McCombie L, Leslie W, Taylor R, Kennon B, Sattar N, Lean MEJ. Beating type 2 diabetes into remission [published online September 13, 2017]. BMJ. doi:10.1136/bmj.j4030

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