Prevention & Remission of DM

Question 1

How to define remission in T2DM?

Answer 1

Keeping HbA1c below 6.5% (48mmol/mol) without the need to take any T2DM medications for at least 2 months

HbA1c is your average blood glucose (sugar) levels for the last two to three months

Question 2

What are concerns with inducing remissions in T2DM patients?

Answer 2

1. The frontline T2DM metformin also has some cardiovascular protective effects, so stopping the drug might compromise such protection
2. Telling people they are in remission might induce worse lifestyle choices and lose these patients from diabetes care system
3. It’s really important for people in remission to get regular health care checks, so any complications can be monitored and any signs of type 2 diabetes coming back can be caught early. Around 10% of
   DiRECT participants revert to T2D glucose levels each year after ending programme

Question 3

What is the suggested population-wide approach to early T2DM management?

Answer 3

stratifying individuals with prediabetes according to estimated risk and only offering individual-level preventive interventions to those at high risk