Achieving Type 2 Diabetes Reversal Seems Way More Common Than Scientists Realized

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About 1.5 million Americans are diagnosed with diabetes each year. The vast majority of cases (90-95%) will be type 2 diabetes, a chronic health condition that can lead to heart disease, kidney disease, vision loss, and more.

For a subset of these patients, this does not have to be the case.

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A great deal of research in recent years has shown that type 2 diabetes can be reversed in the body, through a combination of diet approaches and other types of lifestyle interventions that prompt the disease to heal.

However, it is very difficult to know for sure how many people will be able to successfully achieve such a reversal. After all, hundreds of millions of people around the world currently have diabetes, but millions of them don’t even realize they have the condition.

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Against this background – and outside of scientific trials that specifically measure remission in type 2 diabetes – it is difficult to say how many people may develop the condition before moving forward with successful reversal of it.

However, a new study from Scotland suggests that this phenomenon may be more common than we realized, even without things like scientific interventions and invasive procedures like bariatric surgery.

“We have been able to show, for the first time, that one in 20 people with type 2 diabetes in Scotland achieve remission,” says diabetes clinical researcher Mireille Capto from the University of Edinburgh.

“This is higher than expected and indicates the need for updated guidelines to support clinicians in identifying and supporting these individuals.”

In their study, Captieux and their co-authors evaluated a Scottish National Diabetes Registry, which contains data for more than 99.5 percent of people diagnosed with the condition in the country.

They identified 162,316 people over the age of 30 with type 2 diabetes based on HbA1c (glycated hemoglobin) readings in the diabetes range.

Of this group, during the study window (calendar year 2019), a total of 7,710 people went into remission based on their HbA1c reading falling below the diabetic range of 48 mmol/mol (6.5 percent), which is about 4.8 percent of the group.

The individuals who were more likely to remission were older, had lost weight since their diagnosis, had no history of glucose-lowering therapy or bariatric surgery, and generally had healthy blood readings at the time of their diagnosis.

“Our prevalence estimates are that a reasonably large proportion of people achieve recovery from type 2 diabetes in routine clinical care outside of trials or bariatric surgery settings,” the researchers wrote in their paper.

“The immediate implications of the practice are that these people must be identified and coded appropriately so that they can be given adequate support and follow-up to ensure continued care compliant with diabetes management guidelines. It is important to recognize that diabetes remission may not be permanent.”

Besides helping us support people who appear to have successfully reversed type 2 diabetes on their own, the findings could go some way in helping researchers and health workers identify patients most likely to achieve and maintain remission.

It is not yet clear how these findings from Scotland can be applied to societies elsewhere, but one thing is certain.

With estimates predicting that today’s 460 million diabetics worldwide will expand to around 700 million by 2045, we need more ideas about how to treat this disease, and soon.

The results are reported in MEDICINE PLOS.

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