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Experts agree global definition for type 2 diabetes remission

A group of leading diabetes experts from Europe and America, including our Deputy Head of Care Douglas Twenefour and the DiRECT trial co-lead Professor Roy Taylor, have agreed a global definition for type 2 diabetes remission.

The ground-breaking findings from the Diabetes UK-funded DiRECT trial, which tested a low calorie, weight management programme in primary care, showed us that it’s possible for some people with type 2 diabetes to go into remission.

This mainly happens through weight loss and is more likely if you lose weight as soon as possible after your diabetes diagnosis. Being in remission means your blood glucose (or blood sugar) levels are below the diabetes range without the need for diabetes medication. This can be life changing. 

Until now, there have been some differences across the globe in the criteria used by healthcare professionals and researchers to work out who is in remission and in the language used to describe it.  

This new international agreement on the definition of remission means that everyone will be able to use the same criteria and language. This will help healthcare professionals offer the best, evidence-based support to people with type 2 diabetes and help researchers in their work to understand more about remission. 

New criteria for being in remission

Different criteria have been used around the world and in the UK to establish if a person with type 2 diabetes has gone into remission. The international group of diabetes experts worked together to standardise and simplify the criteria. They have agreed that a person with type 2 diabetes is in remission if:

-    they have had an HbA1c level below 6.5% (48mmol/mol) for a least three months
-    not taken any medications to manage their blood glucose levels during this time.

If you have been told your type 2 diabetes is in remission and you are unsure what these new criteria mean for you, speak to your healthcare team.  

Using the same language

There has been some debate globally on what to call type 2 diabetes remission. Some people use terms like reversal, cure or resolution. We call it remission because there’s no guarantee that you will remain in remission forever. We know blood sugar levels can come back up to the diabetes range, and people in remission still need regular health checks and monitoring for complications of diabetes.

Like us, the international group of diabetes experts agreed that remission is the most appropriate word and that people in remission should continue to have regular health checks such as retinal screening.

Building for a better future 

Diabetes UK welcomes this new global definition of remission as it will play a vital role in helping healthcare professionals provide people with type 2 diabetes with consistent information about remission and the best care. It will also help researchers to gather the data that’s needed to improve remission services and understand more about what helps people go into remission and stay there, and the long-term benefits of being in remission.  

“This landmark publication brings much-needed clarity on how remission of type 2 diabetes should be defined internationally. Helping people with type 2 diabetes to reach and maintain remission is a vital part of Diabetes UK’s work. 

Douglas Twenefour, Deputy Head of Care at Diabetes UK

He said: "We are proud to have funded the ground-breaking DiRECT trial which turned the tide on how we treat type 2 diabetes, resulting in the roll-out of pilot services in England to help people reach remission through weight loss, and to have led the way in developing this international report. The new consensus will help build a more consistent global evidence base and improve our understanding of the long-term benefits of going into remission, such as the impact on diabetes complications including heart disease, stroke and amputation.
“We ask that clinicians provide consistent, evidence-based information to people with type 2 diabetes about the possibility of remission, particularly at diagnosis and in the first few years following it. By prioritising remission as a goal of treatment, more people will have the opportunity to lose weight and keep their blood sugar levels safe, giving them improved quality of life and a better chance of a healthier future.”


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