TY - JOUR
AU - B. Thapa
AU - J. A. Schmittdiel
AU - D. Arterburn
AU - R. Neugebauer
AU - W. Dyer
AU - P. J. O'Connor
AU - J. An
AU - A. E. Cassidy-Bushrow
AU - L. K. Gilliam
AU - S. A. Hooker
AU - M. B. Nolan
AU - C. E. S. Oshiro
AU - T. Thomas
AU - G. Simonson
AU - S. K. Dombrowski
AU - L. A. Rodriguez
A1 - 
AB - OBJECTIVE: To assess the real-world frequency and characteristics associated with type 2 diabetes remission in a large and diverse cohort of U.S. adults. RESEARCH DESIGN AND METHODS: This retrospective cohort study used 2014-2023 electronic health record data from six major U.S. health care delivery systems. The cohort included 556,758 adults (≥18 years) with type 2 diabetes who had one or more HbA1c measurement in 2 years before study entry and evidence of glucose-lowering medication use. Pregnant women or adults who underwent bariatric surgery before or during the study were excluded. Type 2 diabetes remission was defined as HbA1c <6.5% persisting for ≥3 months after cessation of glucose-lowering medications. Multivariate logistic regression was used to identify characteristics associated with type 2 diabetes remission. RESULTS: Over a 3-year follow-up, 2.9% (16,016 adults) achieved type 2 diabetes remission, although 36.9% of those who experienced remission relapsed. The strongest characteristics associated with remission were not receiving glucose-lowering medications at baseline versus three or more medications (odds ratio [OR] 15.9, 95% CI 12.1-21.0), baseline HbA1c <7% vs. ≥11% (OR 3.1, 2.9-3.3) and diabetes duration <1 year versus ≥4 years (OR 2.6, 2.5-2.7). CONCLUSIONS: Type 2 diabetes remission was low among adults without bariatric surgery. The strongest associated characteristics were fewer diabetes medications, lower baseline HbA1c, and shorter diabetes duration. These findings highlight actionable factors to identify patients who may benefit most from targeted interventions. Future research should evaluate the long-term durability and health impacts of remission.
AD - Department of Health System Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA.; Kaiser Permanente Washington Health Research Institute, Seattle, WA.; HealthPartners Institute, Bloomington, MN.; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.; Henry Ford Health, Detroit, MI.; The Permanente Medical Group, Kaiser Permanente, South San Francisco, CA.; Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu, HI.; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA.; International Diabetes Center, HealthPartners Institute, Minneapolis, MN.; Enterprise Pharmacy, Geisinger, Danville, PA.; Center for Pharmacy Innovation and Outcomes, Geisinger, Danville, PA.; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA.
AN - 40734551
BT - Diabetes Care
C5 - Healthcare Disparities
CP - 10
DA - Oct 1
DO - 10.2337/dc25-0530
DP - NLM
IS - 10
JF - Diabetes Care
LA - eng
N2 - OBJECTIVE: To assess the real-world frequency and characteristics associated with type 2 diabetes remission in a large and diverse cohort of U.S. adults. RESEARCH DESIGN AND METHODS: This retrospective cohort study used 2014-2023 electronic health record data from six major U.S. health care delivery systems. The cohort included 556,758 adults (≥18 years) with type 2 diabetes who had one or more HbA1c measurement in 2 years before study entry and evidence of glucose-lowering medication use. Pregnant women or adults who underwent bariatric surgery before or during the study were excluded. Type 2 diabetes remission was defined as HbA1c <6.5% persisting for ≥3 months after cessation of glucose-lowering medications. Multivariate logistic regression was used to identify characteristics associated with type 2 diabetes remission. RESULTS: Over a 3-year follow-up, 2.9% (16,016 adults) achieved type 2 diabetes remission, although 36.9% of those who experienced remission relapsed. The strongest characteristics associated with remission were not receiving glucose-lowering medications at baseline versus three or more medications (odds ratio [OR] 15.9, 95% CI 12.1-21.0), baseline HbA1c <7% vs. ≥11% (OR 3.1, 2.9-3.3) and diabetes duration <1 year versus ≥4 years (OR 2.6, 2.5-2.7). CONCLUSIONS: Type 2 diabetes remission was low among adults without bariatric surgery. The strongest associated characteristics were fewer diabetes medications, lower baseline HbA1c, and shorter diabetes duration. These findings highlight actionable factors to identify patients who may benefit most from targeted interventions. Future research should evaluate the long-term durability and health impacts of remission.
PY - 2025
SN - 0149-5992 (Print); 0149-5992
SP - 1737
EP - 1743+
ST - Clinical and Demographic Characteristics Associated With Diabetes Remission in Six Integrated Health Care Systems: A Retrospective Cohort Study
T1 - Clinical and Demographic Characteristics Associated With Diabetes Remission in Six Integrated Health Care Systems: A Retrospective Cohort Study
T2 - Diabetes Care
TI - Clinical and Demographic Characteristics Associated With Diabetes Remission in Six Integrated Health Care Systems: A Retrospective Cohort Study
U1 - Healthcare Disparities
U3 - 10.2337/dc25-0530
VL - 48
VO - 0149-5992 (Print); 0149-5992
Y1 - 2025
ER -