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