Remission of Type 2 Diabetes: How, When and for Whom? - JAPI Reports

Among various dietary strategies, low-calorie diets (LCDs) and low-carbohydrate diets (LCBDs) have been demonstrated as being effective in facilitating remission of Type 2 diabetes in a targeted population within a clinical setting.

Remission with low-carbohydrate diets may be maintained in the absence of weight loss, however, long-term evidence is limited and remission may not be maintained without long-term carbohydrate restriction, which poses major challenges. In very low-calorie diets (VLCDs), weight loss of 15 kg or greater and maintenance of weight loss is the main driver and predictor of remission.

However, most individuals with Type 2 diabetes were unable to maintain remission beyond 2 years, despite being on very low-calorie diets. Moreover, "re-reversal" or "relapse" of diabetes can occur in a large percentage of individuals who discontinue the dietary restrictions. Hence, regular follow-up by a multi-disciplinary team to ensure the sustainability of the lifestyle modification is crucial to the maintenance of remission of Type 2 diabetes.

Reference: Salis S, Anjana RM, Unnikrishnan R, et al. Remission of Type 2 Diabetes: How, When, and for Whom? J Assoc Physicians India 2022;70(8):74–82.