title: Incidence of remission in adults with type 2 diabetes: the diabetes & aging study.
abstract: OBJECTIVE
  To estimate the incidence of remission in adults with type 2 diabetes not treated with bariatric surgery and to identify variables associated with remission.
  
  
  METHODS
  We quantified the incidence of diabetes remission and examined its correlates among 122,781 adults with type 2 diabetes in an integrated healthcare delivery system. Remission required the absence of ongoing drug therapy and was defined as follows: 1) partial: at least 1 year of subdiabetic hyperglycemia (hemoglobin A1c [HbA₁c] level 5.7-6.4% [39-46 mmol/mol]); 2) complete: at least 1 year of normoglycemia (HbA₁c level <5.7% [<39 mmol/mol]); and 3) prolonged: complete remission for at least 5 years.
  
  
  RESULTS
  The incidence density (remissions per 1,000 person-years; 95% CI) of partial, complete, or prolonged remission was 2.8 (2.6-2.9), 0.24 (0.20-0.28), and 0.04 (0.01-0.06), respectively. The 7-year cumulative incidence of partial, complete, or prolonged remission was 1.47% (1.40-1.54%), 0.14% (0.12-0.16%), and 0.007% (0.003-0.020%), respectively. The 7-year cumulative incidence of achieving any remission was 1.60% in the whole cohort (1.53-1.68%) and 4.6% in the subgroup with new-onset diabetes (<2 years since diagnosis) (4.3-4.9%). After adjusting for demographic and clinical characteristics, correlates of remission included age >65 years, African American race, <2 years since diagnosis, baseline HbA₁c level <5.7% (<39 mmol/mol), and no diabetes medication at baseline.
  
  
  CONCLUSIONS
  In community settings, remission of type 2 diabetes does occur without bariatric surgery, but it is very rare.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA andy.j.karter@kp.org.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Karter
authors.affiliation: Department of Health Policy, School of Public Health and Health Services, The George Washington University, Washington, DC Evolent Health, Arlington, VA.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Nundy
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Parker
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Moffet
authors.affiliation: Department of Medicine, The University of Chicago Medical Center, Chicago, IL Chicago Center for Diabetes Translation Research, The University of Chicago, Chicago, IL Center for Translational and Policy Research of Chronic Disease, The University of Chicago, Chicago, IL.
authors.forename: Elbert S
authors.initials: ES
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D050110:Bariatric Surgery / Q000706:statistics & numerical data; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012074:Remission Induction