Incidence of diabetes remission and association with microvascular and macrovascular complications in patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study using real-world data in Thailand

Abstract

Abstract Objective To estimate the incidence of diabetes remission and relapse among patients with type 2 diabetes (T2DM) and to assess the association between remission status and cardiorenal outcomes using a multistate analysis of long-term real-world data in Thailand. Design Retrospective cohort study using real-world data. Setting Single tertiary care hospital located in Bangkok, Thailand. Participants A total of 29 706 patients newly diagnosed with T2DM who received at least one antidiabetic medication during the study period. Primary and secondary outcome measures Diabetic remission, relapse after remission and cardiorenal outcomes. Diabetes remission was defined as achieving a glycated haemoglobin level <6.5% for at least 90 days after discontinuation of glucose-lowering medications. Results Among 29 706 newly diagnosed patients with T2DM, the 1-year probability of achieving a first diabetes remission was 3.44% (95% CI 3.22 to 3.67), increasing to 8.32% (95% CI 7.94 to 8.71) at 5 years. However, remission was frequently transient, with 38.38% (95% CI 36.22 to 40.63) of patients who achieved first remission experiencing disease relapse within 1 year. The incidence of cardiorenal outcomes was significantly lower among patients who achieved remission than those without remission (HR 0.53; 95% CI 0.46 to 0.61). Conclusions Our study provides real-world evidence that diabetes remission, although often transient, was significantly associated with a decreased risk of cardiorenal complications. These findings highlight the potential benefit of targeting remission early in newly diagnosed T2DM to decrease the risk of cardiorenal complications.