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Consensus Statement Defines Remission of Type 2 Diabetes

Remission defined as HbA1c <6.5 percent for at least three months after cessation of glucose-lowering pharmacotherapy

TUESDAY, Sept. 7, 2021 (HealthDay News) — People with type 2 diabetes can be considered in remission after sustaining hemoglobin A1c (HbA1c) levels <6.5 percent for three months or more without the use of medications, according to a consensus statement published online Aug. 30 in the Journal of Clinical Endocrinology & Metabolism.

Matthew C. Riddle, M.D., from Oregon Health & Science University in Portland, and colleagues proposed nomenclature and objective measures for sustained improvement of glucose levels into the normal range in people with type 2 diabetes, with an aim of establishing a base of information to support future clinical guidance. The consensus statement was published on behalf of the Endocrine Society, the European Association for the Study of Diabetes, Diabetes UK, and the American Diabetes Association.

The researchers proposed remission as the most appropriate descriptive term for sustained metabolic improvement in type 2 diabetes to nearly normal levels. Remission should be defined as HbA1c <6.5 percent, which persists for at least three months after cessation of glucose-lowering pharmacotherapy. When HbA1c is determined to be unreliable, alternative criteria for chronic glycemic control are fasting plasma glucose <126 mg/dL or estimated HbA1c <6.5 percent calculated from continuous glucose monitoring. To document remission, testing of HbA1c should be performed just prior to an intervention and no sooner than three months after intervention initiation and withdrawal of glucose-lowering pharmacotherapy. Subsequent testing to determine long-term maintenance of remission should be conducted at least annually thereafter.

“We also made suggestions for clinicians observing patients experiencing remission and discussed further questions and unmet needs regarding predictors and outcomes,” Riddle said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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