Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetes

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 versus 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 HbA1c < 6.5% (48 mmol/mol) 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.

Automated summary

Improvement of glucose levels in people with diabetes can occur spontaneously or after medical interventions. Newer forms of treatment may lead to more sustained improvement. However, the terminology and objective measures for defining this process are not established, and the long-term risks and benefits are not well understood. An international expert group proposed the term "remission" and HbA1c < 6.5% as the usual diagnostic criterion. They also suggested active observation and further research on predictors and outcomes of remission.