Found a 2019 study on T2 diabetics in Scotland, guess what percentage were classed as In Remission

Ronancastled said:

Compared to people who did not achieve remission, people in remission of type 2 diabetes tended to be older; have a lower HbA1c at diagnosis; have never taken any glucose-lowering medication; have lost weight since the diagnosis of diabetes; and have had bariatric surgery.

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The odds ratio's are interesting:

Lower HbA1c 1.31
Older age 1.48
Weight loss 4.45
Bariatric surgery 11.9

and <drumrolls>

Never taken any glucose-lowering medication 14.6

Looking at the conflict of interests section, then some of the authors must be very disapointed that the Odds Ratio for "No history of GLT" scored so highly.

Very interesting - thanks for sharing.

Oldvatr said:

Looking at the conflict of interests section, then some of the authors must be very disapointed that the Odds Ratio for "No history of GLT" scored so highly.

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Doesn't that just mean that if you haven't had diabetes "bad enough" to need medication you stand more chance of remission?

Mr_Pot said:

Doesn't that just mean that if you haven't had diabetes "bad enough" to need medication you stand more chance of remission?

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Not really as the official advice is to start all T2s on metformin immediately - I refused it and went low carb instead even though diet was not suggested apart from use less sugar.

Mr_Pot said:

Doesn't that just mean that if you haven't had diabetes "bad enough" to need medication you stand more chance of remission?

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There are classes of patients who get labelled as diabetic or treated as diabetic. PCOS and GD are two that immediately spring to mind.

The NICE guidelines when I was DX'ed some 30 years ago was to initiate lifestyle and weight loss program before introducing medication. This is still in the NICE guidelines, and it is not anything new that for some this was all that was necessary - it is a well trod route of old. We know from ND et al that weight loss can lead to remission, so again it is not rocket science, and offers a cheap route to that outcome for the NHS bean counters. My comment was an observation that the study was manned by personnel who worked with the big drug and insulin suppliers, and they would not be celebrating this study or using it in their marketing brochures.

Holy **** thats a lot of diabetics in a population of 5 million.

The graphs show the power of weight loss. The correlation of age to remission may be a survivor bias; there are unmanaged diabetics, there are old diabetics, but there are probably not that many old, unmanaged diabetics.

Scottish diabetes education for new diabetics does make a decent emphasis on remission as a goal, I wonder how much this study was a factor in that.

Sax said:

Holy **** thats a lot of diabetics in a population of 5 million.

The graphs show the power of weight loss. The correlation of age to remission may be a survivor bias; there are unmanaged diabetics, there are old diabetics, but there are probably not that many old, unmanaged diabetics.

Scottish diabetes education for new diabetics does make a decent emphasis on remission as a goal, I wonder how much this study was a factor in that.

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I would propose that the older folk tend to be managed within the care system and their medication routine will be closely managed. This could be in a care facility or as home assisted. Remember that this report used data of registered diabetics only and again only those actively monitored with at least 2 HbA1c tests in that year. In my case I would not have been included since I only had 1 in the last 3 years and no face to face reviews.