Consensus report: definition and interpretation of remission in type 2 diabetes

Abstract

Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often due to newer forms of treatment. However, terminology for describing this process and objective measures for defining it are not well established, and the long-term risks vs benefits of its attainment are not well understood. To update prior discussions of this issue, an international expert group was convened by the American Diabetes Association to propose nomenclature and principles for data collection and analysis, with the goal of establishing a base of information to support future clinical guidance. This group proposed 'remission' as the most appropriate descriptive term, and HbA 1c <48 mmol/mol (6.5%) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion. The group also made suggestions for active observation of individuals experiencing a remission and discussed further questions and unmet needs regarding predictors and outcomes of remission. This Consensus Report is jointly published in The Journal of Clinical Endocrinology & Metabolism, published by Oxford University Press on behalf of the Endocrine Society; Diabetologia, published by Springer-Verlag, GmbH, on behalf of the European Association for the Study of Diabetes; Diabetic Medicine, published by Wiley on behalf of Diabetes UK; and Diabetes Care, published by the American Diabetes Association.A consensus report of a particular topic contains a comprehensive examination and is authored by an expert panel and represents the panel's collective analysis, evaluation and opinion. The article was reviewed for EASD by its Committee on Clinical Affairs.

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Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT

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