Nakhleh A, Halfin E, Shehadeh N. Remission of type 2 diabetes mellitus. World J Diabetes 2024; 15(7): 1384-1389 [PMID: 39099816 DOI: 10.4239/wjd.v15.i7.1384]
Corresponding Author of This Article
Afif Nakhleh, MD, Doctor, Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, 8 Haaliya Hashniya Street, Haifa 3109601, Israel. anakhleh@gmail.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jul 15, 2024; 15(7): 1384-1389 Published online Jul 15, 2024. doi: 10.4239/wjd.v15.i7.1384
Remission of type 2 diabetes mellitus
Afif Nakhleh, Elya Halfin, Naim Shehadeh
Afif Nakhleh, Naim Shehadeh, Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, Haifa 3109601, Israel
Afif Nakhleh, Elya Halfin, Naim Shehadeh, Diabetes and Endocrinology Clinic, Maccabi Healthcare Services, Haifa 3299001, Israel
Afif Nakhleh, Naim Shehadeh, The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
Author contributions: Nakhleh A drafted the manuscript; Nakhleh A, Halfin E, and Shehadeh N edited and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Afif Nakhleh, MD, Doctor, Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, 8 Haaliya Hashniya Street, Haifa 3109601, Israel. anakhleh@gmail.com
Received: December 30, 2023 Revised: April 13, 2024 Accepted: April 28, 2024 Published online: July 15, 2024 Processing time: 190 Days and 13.7 Hours
Abstract
The surge in type 2 diabetes mellitus (T2DM) is tightly linked to obesity, leading to ectopic fat accumulation in internal organs. Weight management has become a cornerstone of T2DM treatment, with evidence suggesting that significant weight loss can induce remission. Remission, defined as sustained hemoglobin (HbA1c) below 6.5% for at least 3 months without medication, can be achieved through various approaches, including lifestyle, medical, and surgical interventions. Metabolic bariatric surgery offers significant remission rates, particularly for patients with severe obesity. Intensive lifestyle modifications, including low-calorie diets and exercise, have also demonstrated significant potential. Medications like incretin-based agents show robust results in improving beta-cell function, achieving glycemic control, and promoting weight loss. While complete remission without medication may not be attainable for everyone, especially those with severe insulin resistance or deficiency, early and aggressive glycemic control remains a crucial strategy. Maintaining HbA1c below 6.5% from the time of diagnosis reduces the risk of long-term complications and mortality. Moreover, considering a broader definition of remission, encompassing individuals with sustained control on medication, could offer a more comprehensive and inclusive approach to managing this chronic disease.
Core Tip: The rise in type 2 diabetes mellitus (T2DM) parallels the obesity epidemic. Notably, significant weight loss can induce remission, with hemoglobin levels below 6.5% for three months without medication. Herein we present the recent data on a variety of approaches, including lifestyle interventions, glucose-lowering and weight management medications and metabolic surgery that hold promise for inducing T2DM remission.
