Weight loss plays crucial role in diabetes remission

Bodyweight loss appears to have a strong, independent dose-response association with type 2 diabetes (T2D) remission among people with obesity or overweight, according to the results of a meta-analysis.

Researchers searched multiple online databases for randomized controlled trials conducted in individuals with T2D and overweight or obesity. The outcome was the occurrence of complete diabetes remission (HbA_1c <6.0 percent [42 mmol/mol] and/or fasting plasma glucose [FPG] <100 mg/dL [5.6 mmol/L] without the use of glucose-lowering drugs) or partial diabetes remission (HbA_1c <6.5 percent [48 mmol/mol] and/or FPG <126 mg/dL [7.0 mmol/L] with no use of glucose-lowering drugs) at least 1 year after a bodyweight loss intervention.

The search yielded 22 relevant publications, in which 29 outcome measures of complete diabetes remission and 33 outcome measures of partial remission were reported. The bias risk was low in all quality domains.

Pooled data showed that the likelihood of achieving complete diabetes remission 1 year after the intervention markedly increased with greater weight loss. The percentage of participants who achieved complete remission 1 year after the intervention was 0.7 percent (95 percent confidence interval [CI], 0.1–4.6) among those who lost <10 percent of their bodyweight, 49.6 percent (95 percent CI, 40.4–58.9) among those who lost 20–29 percent of their bodyweight, and 79.1 percent (95 percent CI, 68.6–88.1) among those who lost at least 30 percent of their bodyweight. None of the studies reported on complete remission among those who lost 10–19 percent of their bodyweight.

Partial remission 1 year after the intervention occurred in 5.4 percent (95 percent CI, 2.9–8.4) of participants who lost <10 percent of their bodyweight, 48.4 percent (95 percent CI, 36.1–60.8) of those who lost 10–19 percent of their bodyweight, 69.3 percent (95 percent CI, 55.8–81.3) of those who lost 20–29 percent of their bodyweight, and 89.5 percent (95 percent CI, 80.0–96.6) of those who lost at least 30 percent of their bodyweight.

Notably, the probability of achieving complete and partial remission increased by 2.17 and 2.74 percentage points, respectively, for every 1-percentage point decrease in bodyweight.

Remission showed no association with factors such as age, sex, race, diabetes duration, baseline BMI, HbA_1c, insulin use, or type of bodyweight loss intervention.