Diabetes & Metabolism Journal

Review

Metabolic Risk/Epidemiology
Not Control but Conquest: Strategies for the Remission of Type 2 Diabetes Mellitus: Jinyoung Kim, Hyuk-Sang Kwon; Diabetes Metab J. 2022;46(2):165-180. Published online March 24, 2022; DOI: https://doi.org/10.4093/dmj.2021.0377

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A durable normoglycemic state was observed in several studies that treated type 2 diabetes mellitus (T2DM) patients through metabolic surgery, intensive therapeutic intervention, or significant lifestyle modification, and it was confirmed that the functional β-cell mass was also restored to a normal level. Therefore, expert consensus introduced the concept of remission as a common term to express this phenomenon in 2009. Throughout this article, we introduce the recently updated consensus statement on the remission of T2DM in 2021 and share our perspective on the remission of diabetes. There is a need for more research on remission in Korea as well as in Western countries. Remission appears to be prompted by proactive treatment for hyperglycemia and significant weight loss prior to irreversible β-cell changes. T2DM is not a diagnosis for vulnerable individuals to helplessly accept. We attempt to explain how remission of T2DM can be achieved through a personalized approach. It may be necessary to change the concept of T2DM towards that of an urgent condition that requires rapid intervention rather than a chronic, progressive disease. We must grasp this paradigm shift in our understanding of T2DM for the benefit of our patients as endocrine experts.

Citations

Citations to this article as recorded by

Weight change in patients with new‐onset type 2 diabetes mellitus and its association with remission: Comprehensive real‐world data
Jinyoung Kim, Bongseong Kim, Mee Kyoung Kim, Ki‐Hyun Baek, Ki‐Ho Song, Kyungdo Han, Hyuk‐Sang Kwon
Diabetes, Obesity and Metabolism.2024; 26(2): 567. CrossRef
Mechanisms and the strategy for remission of type 2 diabetes mellitus
Tien‐Jyun Chang
Journal of Diabetes Investigation.2023; 14(3): 351. CrossRef
Remission of type 2 diabetes: A critical appraisal
Michele Ricci, Juan José Mancebo-Sevilla, Lidia Cobos Palacios, Jaime Sanz-Cánovas, Almudena López-Sampalo, Halbert Hernández-Negrin, Miguel Angel Pérez-Velasco, Luis M. Pérez-Belmonte, Maria Rosa Bernal-López, Ricardo Gómez-Huelgas
Frontiers in Endocrinology.2023;[Epub] CrossRef
Incidence and predictors of remission and relapse of type 2 diabetes mellitus in Japan: Analysis of a nationwide patient registry (JDDM73)
Kazuya Fujihara, Laymon Khin, Koshiro Murai, Yurie Yamazaki, Kahori Tsuruoka, Noriko Yagyuda, Katsuya Yamazaki, Hiroshi Maegawa, Shiro Tanaka, Satoru Kodama, Hirohito Sone
Diabetes, Obesity and Metabolism.2023; 25(8): 2227. CrossRef
Use of SGLT2 inhibitors after bariatric/metabolic surgery: Risk/benefit balance
André J. Scheen
Diabetes & Metabolism.2023; 49(4): 101453. CrossRef
Cardiovascular Risk Reduction in Type 2 Diabetes: Further Insights into the Power of Weight Loss and Exercise
Seung-Hwan Lee
Endocrinology and Metabolism.2023; 38(3): 302. CrossRef
Unlocking the Potential of Type 2 Diabetes Mellitus Remission
Prakriti Sharma, Swarupa Chakole
Cureus.2023;[Epub] CrossRef
Global research trends of diabetes remission: a bibliometric study
Xue Yang, Zhiwei He, Qilin Chen, Yu Chen, Guofang Chen, Chao Liu
Frontiers in Endocrinology.2023;[Epub] CrossRef
Gastrointestinal adverse events of tirzepatide in the treatment of type 2 diabetes mellitus: A meta-analysis and trials sequential analysis
Keke Tong, Shuang Yin, Yunfeng Yu, Xinyu Yang, Gang Hu, Fei Zhang, Zhenjie Liu
Medicine.2023; 102(43): e35488. CrossRef
Optimal dose of tirzepatide for type 2 diabetes mellitus: A meta-analysis and trial sequential analysis
Yunfeng Yu, Gang Hu, Shuang Yin, Xinyu Yang, Manli Zhou, Weixiong Jian
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef

Original Article

Clinical Care/Education
Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment: Yeoree Yang, Jeong-Ah Shin, Hae Kyung Yang, Seung-Hwan Lee, Seung-Hyun Ko, Yu-Bae Ahn, Kun-Ho Yoon, Jae-Hyoung Cho; Diabetes Metab J. 2016;40(6):454-462. Published online October 11, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.6.454

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Abstract PDF PubReader

Background

There were a limited number of studies about β-cell function after insulin initiation in patients exposed to long durations of sulfonylurea treatment. In this study, we aimed to evaluate the recovery of β-cell function and the efficacy of concurrent sulfonylurea use after the start of long-acting insulin.

Methods

In this randomized controlled study, patients with type 2 diabetes mellitus (T2DM), receiving sulfonylurea for at least 2 years with glycosylated hemoglobin (HbA1c) >7%, were randomly assigned to two groups: sulfonylurea maintenance (SM) and sulfonylurea reduction (SR). Following a 75-g oral glucose tolerance test (OGTT), we administered long-acting basal insulin to the two groups. After a 6-month follow-up, we repeated the OGTT.

Results

Among 69 enrolled patients, 57 completed the study and were analyzed: 31 in the SM and 26 in the SR group. At baseline, there was no significant difference except for the longer duration of diabetes and lower triglycerides in the SR group. After 6 months, the HbA1c was similarly reduced in both groups, but there was little difference in the insulin dose. In addition, insulin secretion during OGTT was significantly increased by 20% to 30% in both groups. A significant weight gain was observed in the SM group only. The insulinogenic index was more significantly improved in the SR group.

Conclusion

Long-acting basal insulin replacement could improve the glycemic status and restore β-cell function in the T2DM patients undergoing sulfonylurea-based treatment, irrespective of the sulfonylurea dose reduction. The dose reduction of the concurrent sulfonylurea might be beneficial with regard to weight grain.

Citations

Citations to this article as recorded by

Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes: A Real-World, Prospective, Non-interventional Study Across Six Countries
Gregory R. Fulcher, Shahid Akhtar, Saleh J. Al-Jaser, Johan Medina, Mafauzy Mohamed, Nemencio A. Nicodemus, Anne Helene Olsen, Kiran P. Singh, Adri Kok
Advances in Therapy.2022; 39(8): 3735. CrossRef
Use of Insulin Glargine 100 U/mL for the Treatment of Type 2 Diabetes Mellitus in East Asians: A Review
Takahisa Hirose, Ching-Chu Chen, Kyu Jeung Ahn, Jacek Kiljański
Diabetes Therapy.2019; 10(3): 805. CrossRef
Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017
Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
Diabetes & Metabolism Journal.2017; 41(5): 367. CrossRef
Insulin therapy for adult patients with type 2 diabetes mellitus: a position statement of the Korean Diabetes Association, 2017
Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
The Korean Journal of Internal Medicine.2017; 32(6): 967. CrossRef

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