Introduction

Type 2 diabetes is considered a chronic and progressive disease. The term diabetes in remission has no consensus definition and the question whether diabetes “remission” or “cure” can achieve any long-term benefits in people with type 2 diabetes remains unclear. The aim of our study was a review of our district wide diabetes population to determine the epidemiology and clinical characteristics of those who had a diagnosis of diabetes but did not meet the diagnostic criteria for diabetes at the point of assessment in 2014 and then to review their diabetes outcomes over a 5-year time frame.

Methods

In a whole population based non-interventional epidemiological study amongst 17,308 people with diabetes, we identified 991 with diet treated type 2 diabetes who met the baseline criteria for diabetes in remission (HbA1c < 48 mmol/mol (6.5%)). Over the next 5 years, 385 (39%) people had a cumulative HbA1c attainment of <48 mmol/mol (6.5%) and remained free of diabetes medication.

Results

In this erstwhile remission group only 130 (13%) were free of any vasculopathy, whilst 255 (26%) had some form of micro or macrovascular disease, of which 64 people had been without micro or macrovascular vascular complications at baseline. Only 20 people had a HbA1c consistently ≤37 mmol/mol (5.7%) who were free of diabetes vascular complications and of diabetes medication.

Conclusions

The definition of ‘diabetes in remission’ remains unclear most especially regarding the inclusion of baseline prevalent or incident macro or microvascular disease, the durability of potential remission is poor, and the likelihood of cure is remote.

中文翻译：

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对可能缓解的糖尿病的流行病学和自然病程的 5 年评估

介绍

2 型糖尿病被认为是一种慢性进行性疾病。糖尿病缓解期这一术语没有统一的定义，糖尿病“缓解”或“治愈”能否在 2 型糖尿病患者中实现任何长期益处的问题仍不清楚。我们研究的目的是对我们地区范围的糖尿病人群进行回顾，以确定在 2014 年评估时诊断为糖尿病但不符合糖尿病诊断标准的人群的流行病学和临床特征，然后回顾他们的5 年时间范围内的糖尿病结果。

方法

在一项针对 17,308 名糖尿病患者的基于全人群的非干预流行病学研究中，我们确定了 991 名接受饮食治疗的 2 型糖尿病患者符合糖尿病缓解的基线标准（HbA1c < 48 mmol/mol (6.5%)）。在接下来的 5 年中，385 人 (39%) 的 HbA1c 累积达到 <48 mmol/mol (6.5%) 并且没有服用糖尿病药物。

结果

在这个以前的缓解组中，只有 130 (13%) 人没有任何血管病变，而 255 (26%) 人患有某种形式的微血管或大血管疾病，其中 64 人在基线时没有微血管或大血管并发症。只有 20 人的 HbA1c 始终≤37 mmol/mol (5.7%)，并且没有糖尿病血管并发症和糖尿病药物治疗。

结论

“缓解期糖尿病”的定义仍不清楚，尤其是在纳入基线流行或偶发的大血管或微血管疾病方面，潜在缓解的持久性较差，治愈的可能性很小。