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DiabetesIndia 2022 - Promises and Pitfalls of Remission of Diabetes

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Dr Sujoy Majumdar, Kolkata    02 December 2022

  • The term used to describe a sustained metabolic improvement in T2DM to nearly normal levels should be remission of diabetes and not a reversal of DM.
  • Remission should be defined as a return of HbA1c to <6.5% (<48 mmol/mol) that occurs spontaneously or following an intervention and that persists for at least 3 months in the absence of usual glucose-lowering pharmacotherapy.
  • When HbA1c is determined to be an unreliable marker of chronic glycemic control, FPG <126 mg/dL or eA1c <6.5% calculated from CGM values can be used as alternate criteria.
  • Testing of HbA1c to document a remission should be performed just prior to an intervention and no sooner than 3 months after initiation of the intervention and withdrawal of any glucose-lowering pharmacotherapy.
  • Subsequent testing to determine long-term maintenance of remission should be done at least yearly thereafter, together with the testing routinely recommended for potential complications of diabetes.
  • Reversal of diabetes remains a distant goal to date.

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