Clinical and Metabolic Characteristics of Spontaneous Remission in Type 2 Diabetes: A Real-World Study from South...

This study aimed to evaluate clinical characteristics and outcomes of individuals with type 2 diabetes (T2D) who achieved spontaneous remission without structured intervention.

We examined electronic medical records of 243,400 adults with T2D attending a tertiary care center in India between 1993 and 2018. Spontaneous remission was defined as achieving glycated hemoglobin (HbA1c) < 6.5% for at least 3 months without glucose-lowering medication in those who earlier had HbA1c ≥ 6.5%. A matched group without remission was selected for comparison.

Among 243,400 individuals with T2D, 275 (0.11%) achieved spontaneous remission. Remission occurred in 0.34% of individuals with baseline HbA1c < 7.0%, 0.13% with HbA1c 7.0-7.9%, and 0.08% with HbA1c ≥ 8.0%. Diabetes recurred in 69%, 80%, and 87% of these respective groups, after a median remission duration of 2.1 years. Sustained remission was observed in 55 individuals (0.02%). Individuals who achieved remission were older, had lower body weight and glucose levels, shorter duration, higher C-peptide, and greater physical activity. Relapse was associated with higher body weight and postprandial glucose levels. Individuals who had longer remission had greater weight loss.

Spontaneous remission of T2D is rare and mostly transient. Higher baseline HbA1c predicts relapse, while sustained weight loss is strongly associated with long-term remission.