From the Guidelines
Type 2 diabetes remission is achievable through several interventions, with total diet replacement (TDR) demonstrating the highest success rate, leading to a large increase in T2D remission by a median of 54% from baseline, when compared with standard care. According to a recent meta-analysis 1, TDR has been shown to be the most effective intervention for achieving type 2 diabetes remission, with a high certainty of evidence. The factors associated with achieving remission include significant weight loss, with every 1 kg of weight loss associated with a 7% higher chance of remission at 5 years, regardless of specific diet regimens or lifestyle interventions 1.
Some key points to consider when attempting to achieve type 2 diabetes remission include:
- Early intervention is crucial, as patients with shorter diabetes duration have substantially higher remission rates 1
- Loss of >10% of baseline body weight in the first year after diagnosis is associated with a 70% higher chance of remission at 5 years 1
- Other interventions, such as meal replacement and Mediterranean diet, may also lead to T2D remission, but with lower success rates and lower certainty of evidence 1
- Bariatric surgery and very low-calorie diets (VLCDs) have also been shown to be effective in achieving type 2 diabetes remission, with success rates of 30-63% and 36-46%, respectively 1
Overall, the evidence suggests that total diet replacement is the most effective intervention for achieving type 2 diabetes remission, with a median success rate of 54%, and that significant weight loss and early intervention are key factors associated with achieving remission.
From the Research
Factors for Achieving Type 2 Diabetes Remission
- Lifestyle intervention, including diet and exercise, is a key factor in achieving type 2 diabetes remission 2, 3, 4, 5, 6
- Weight loss is a significant predictor of remission, with greater weight loss associated with higher rates of remission 3, 4, 6
- Dietary approaches, such as low-energy diets, low-carbohydrate diets, and total diet replacement, can support the achievement of euglycaemia and potentially remission 3, 6
- Patient-centered care, including personalized lifestyle interventions and support, is important for achieving remission 5
Rates of Achieving Type 2 Diabetes Remission
- The rate of remission achievable with lifestyle intervention is modest, with 11.5% of participants achieving remission at 1 year and 7.3% at 4 years in one study 4
- A study of the NHS Type 2 Diabetes Path to Remission Programme found that 27% of participants who started the program and had two HbA1c measurements recorded achieved remission, with a mean weight loss of 13.4% 6
- Another study found that 32% of participants who completed a 12-month behavioral intervention achieved remission, with a mean weight loss of 14.4% 6
- Remission rates can vary depending on the specific intervention and population, with some studies suggesting that remission is more achievable in newly diagnosed patients with good glycemic control and without obesity 2