Remission of Type 2 Diabetes Following a Short-term Intervention With Insulin Glargine, Metformin, and Dapagliflozin

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Natalia McInnes 1 2, Stephanie Hall 2, Farah Sultan 1, Ronnie Aronson 3, Irene Hramiak 4, Stewart Harris 4, Ronald J Sigal 5, Vincent Woo 6, Yan Yun Liu 2, Hertzel C Gerstein 1 2

Main idea: The primary outcome of diabetes remission at 24 weeks was not statistically significantly different. However, our overall results suggest that some patients with early type 2 diabetes are able to achieve sustained diabetes remission following a short-term intensive intervention.

Abstract

Objective: To examine diabetes remission following a short-term intensive metabolic intervention combining lifestyle and glucose-lowering approaches.

Methods: We conducted an open-label, randomized controlled trial in 154 patients with type 2 diabetes up to 8 years in duration. At 12 weeks, diabetes medications were discontinued in participants with hemoglobin A1c (HbA1C) < 7.3% (56mol/mol) The primary outcome was complete or partial diabetes remission at 24 weeks. Main secondary outcomes were at 36, 48, and 64 weeks.

Results: The primary outcome was achieved in 19 (24.7%) intervention group participants and 13 (16.9%) control group participants at 24 weeks. The relative risks of remission at 36, 48, and 64 weeks were 2.4, 2.1, and 1.8. In an exploratory analysis, the intervention reduced the hazard of diabetes relapse with overt hyperglycemia by 43%.

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