Remission of type 2 diabetes: a position statement from the Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS)


  • Dinesh Nagi
  • Clare Hambling
  • Roy Taylor



remission, type 2 diabetes, weight loss, pathophysiology of type 2 diabetes, beta cell function, bariatric surgery


This joint Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS) position statement reviews the current evidence related to remission of type 2 diabetes. We believe that there is ample evidence to support the statement that it is possible to achieve remission in type 2 diabetes. In putting this document together, both societies recognise that this is an area of huge clinical significance and has suggested a pragmatic definition of type 2 diabetes and the importance of the proposed definition for clinicians in primary care. This proposal makes firm recommendations about the importance of life style and weight loss in achieving remission of type 2 diabetes and also recognises the different strategies that can be used to achieve remission of type 2 diabetes; however, most of these involve sustained weight loss. This is particularly true in the early stages of type 2 diabetes when irreversible damage to the beta cell has not happened. A further recommendation is that the term ‘remission’ of type 2 diabetes should be used in preference to other previous terms such as ‘diabetes resolved’, and should be used for the purpose of clinical coding. It is of key importance that, in those individuals who achieve and sustain remission, robust systems are in place to call and recall these individuals for annual review and that primary care is adequately resourced to facilitate this. Finally, we urge the national and international diabetes societies to work together in further refining the proposed definition as new evidence emerges based on ongoing research.


Pories WJ, Caro JF, Flickinger EG, Meelheim HD, Swanson MS. The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass. Ann Surg 1987;206:316–23.

Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351:2683–93.

Bouchardat A. De la Glycosurie ou Diabète Sucré. Paris: Baillière, 1875.

Sheth H, Sheth J, Sheth F, Burn J. The poor patient with diabetes 'should live like a saint'. Diabet Med 2016;33:134–5.

Wing RR, Blair E, Marcus M, Epstein LH, Harvey J. Year-long weight loss treatment for obese patients with type II diabetes: does including an intermittent very-low-calorie diet improve outcome? Am J Med 1994;97:354–62.

Wing RR, Marcus MD, Salata R, Epstein LH, Miaskiewicz S, Blair EH. Effects of a very-low-calorie diet on long-term glycemic control in obese type 2 diabetic subjects. Arch Intern Med 1991;151:1334–40.

Henry RR, Schaeffer L, Olefsky JM. Glycaemic effects of intensive caloric restriction and isocaloric refeeding in non-insulin dependent diabetes mellitus. J Clin Endocrinol Metab 1985;61:917–25.

Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 2011; 54:2506–14.

Steven S, Hollingsworth KG, Small PK, et al. Very low calorie diet and 6 months of weight stability in type 2 diabetes: pathophysiological changes in responders and nonresponders. Diabetes Care 2016;39:158–65.

Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, et al. Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for beta cell recovery. Cell Metab 2018;28:547–56.e3.

Taylor R. Calorie restriction and reversal of type 2 diabetes. Expert Rev Endocrinol Metab 2016;11:521–8.

Paisey RB, Frost J, Harvey P, et al. Five year results of a prospective very low calorie diet or conventional weight loss programme in type 2 diabetes. J Hum Nutr Diet 2002;15:121–7.

LookAhead Research Group. Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study. Obesity 2014;22:5–13.

Taylor R, Barnes AC. Can type 2 diabetes be reversed and how can this best be achieved? James Lind Alliance research priority number one. Diabet Med 2019;36:308–15.

McCombie L, Leslie W, Taylor R, Kennon B, Sattar N, Lean MEJ. Beating type 2 diabetes into remission. BMJ 2017;358:j4030.

Buse JB, Caprio S, Cefalu WT, et al. How do we define cure of diabetes? Diabetes Care 2009;32:2133–5.

The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997;20:1183–97.

Taylor R, Barnes A. From new understanding of type 2 diabetes to practical management. Diabetologia 2018;61:273–83.

Pearce IA, Ilango B, Sells RA, Wong D. Stabilisation of diabetic retinopathy following simultaneous pancreas and kidney transplant. Br J Ophthalmol 2000;84:736–40.

Sjostrom L, Peltonen M, Jacobson P, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014;311:2297–304.

Gregg EW, Chen H, Wagenknecht LE, et al. Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA 2012; 308:2489–96.

Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005;82(1 Suppl):222S–5S.

Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet 2018;391:541–51.






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