Nearly 5% of adults diagnosed with type 2 diabetes in Scotland were in remission in 2019

Compared with people who did not achieve remission, those in remission tended to be older, to have a lower HbA1c level at diagnosis, to have never taken any glucose-lowering medication, to have lost weight since diabetes diagnosis, and to have had bariatric surgery.

A recent cross-sectional study found that about one in 20 people with type 2 diabetes were in remission and that age, weight loss, and other factors were associated with diabetes remission.

Researchers used a national type 2 diabetes register to estimate the prevalence of diabetes remission in all adults with type 2 diabetes in Scotland ages 30 years and older who had at least one HbA1c measurement of 6.5% or greater at or after type 2 diabetes diagnosis, had at least one HbA1c measurement recorded in 2019, and were alive on Dec. 31, 2019. From Jan. 1 through Dec. 31, 2019, they assessed participants for diabetes remission, defined as all HbA1c values below 6.5% in the absence of glucose-lowering therapy for a continuous duration of 365 days or more before the date of the last recorded HbA1c in 2019. Results were published Nov. 2 by PLOS Medicine.

Of 162,316 individuals, 56% were ages 65 years or older in 2019, 64% had had type 2 diabetes for at least six years, and at least 74% were White. The median body mass index at diagnosis was 32.3 kg/m2. Overall, 7,710 people (4.8%; 95% CI, 4.7% to 4.9%) were in remission of type 2 diabetes. Factors associated with remission were older age (odds ratio [OR], 1.48 [95% CI, 1.34 to 1.62]; P<0.001 for people ages ≥75 years vs. ages 45 to 54 years), HbA1c level less than 6.5% at diagnosis (OR, 1.31 [95% CI, 1.24 to 1.39]; P<0.001 compared to 6.5% to 6.9%), no history of using glucose-lowering therapy (OR, 14.6 [95% CI, 13.7 to 15.5]; P<0.001), weight loss from diagnosis to 2019 (OR, 4.45 [95% CI, 3.89 to 5.10]; P<0.001 for ≥15 kg lost compared to 0 to 4.9 kg gained), and previous bariatric surgery (OR, 11.9 [95% CI, 9.41 to 15.1]; P<0.001).

The study was limited by its use of a restricted subset of possible definitions of diabetes remission, as well as by missing data, the authors noted. “Our findings provide a useful basis for the evaluation of the multifactorial approaches to both remission and prevention of diabetes that are currently being introduced and also highlight the need for guidelines to support definition of remission, management, and follow-up of people that achieve remission,” they concluded.