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

The global prevalence of diabetes in adults has been increasing over recent decades. The total number of people with diabetes is projected to increase from 537 million in 2021 to 784 million by 2045. India has more than 74 million people living with diabetes, the second highest number worldwide.

Journal of the Association of Physician of India (JAPI) reports the possibility of remission of type2 diabetes.

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.