The Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS) have today released a joint Position Statement on remission of type 2 diabetes.
The key messages of the statement are that it is possible for people with type 2 diabetes to achieve remission through several means, all of which require sustainable weight loss. Of the various strategies shown to be effective, weight loss through bariatric surgery or a low-calorie diet remain the most successful methods. Both require ongoing, sustained modest restriction of energy intake and increase in daily physical activity.
The two organisations also highlight the lack of consensus, nationally or internationally, on the definition of remission, including the biochemical parameters that must have been achieved and maintained following the discontinuation of all glucose-lowering therapies. They propose the following pragmatic criteria:
- Weight loss.
- Fasting plasma glucose or HbA1c below the World Health Organization diagnostic thresholds (<7 mmol/L or <48 mmol/mol [6.5%], respectively) on two occasions separated by at least 6 months.
- The attainment of these glycaemic parameters following the complete cessation of all glucose-lowering therapies.
Finally, the organisations highlight that consistent coding for remission of diabetes is required to facilitate safe follow-up and data collection in routine clinical practice. They strongly recommend that “diabetes resolved” clinical codes should not be employed in clinical practice but that “diabetes in remission” codes should preferentially be adopted. Robust systems should be in place to call and recall those individuals who achieve and sustain remission for annual review, and primary care should be adequately resourced to facilitate this.
Commenting on the launch, Dinesh Nagi, Chair of the ABCD Committee, said: “We understand the importance of this consensus definition and have asked other organisations to work with us to achieve an international consensus on defining remission of type 2 diabetes.
“New evidence is emerging that not only it is possible to achieve remission of type 2 diabetes but it can be sustained for a longer period of time. This has significant implication for healthcare but more importantly for people who have type 2 diabetes. ABCD and PCDS strongly believe that ongoing support and regular review of those who successfully achieve remission is vital.
“My sincere thanks to all those who contributed to this important work.”
Click here to read the Position Statement in full.
