King's College London

Research portal

Consensus report: definition and interpretation of remission in type 2 diabetes

Research output: Contribution to journalArticlepeer-review

Matthew C. Riddle, William T. Cefalu, Philip H. Evans, Hertzel C. Gerstein, Michael A. Nauck, William K. Oh, Amy E. Rothberg, Carel W. le Roux, Francesco Rubino, Philip Schauer, Roy Taylor, Douglas Twenefour

Original languageEnglish
Pages (from-to)2359–2366
Number of pages8
Issue number11
Early online date30 Aug 2021
E-pub ahead of print30 Aug 2021
PublishedNov 2021

Bibliographical note

Funding Information: MCR reports receiving research grant support through Oregon Health & Science University from Eli Lilly & Co., Novo Nordisk, and AstraZeneca and honoraria for consulting from Adocia, Intercept and Theracos. HCG holds the McMaster–Sanofi Population Health Institute Chair in Diabetes Research and Care and reports research grants from Eli Lilly & Co., AstraZeneca, Merck, Novo Nordisk and Sanofi; honoraria for speaking from AstraZeneca, Boehringer Ingelheim, Eli Lilly & Co., Novo Nordisk, and Sanofi; and consulting fees from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly & Co., Merck, Novo Nordisk, Janssen, Sanofi and Kowa. MAN has been a member on advisory boards or has consulted for AstraZeneca, Boehringer Ingelheim, Eli Lilly & Co., GlaxoSmithKline, Menarini/Berlin Chemie, Merck, Sharp & Dohme, and Novo Nordisk; has received grant support from AstraZeneca, Eli Lilly & Co., Menarini/Berlin Chemie, Merck, Sharp & Dohme, and Novo Nordisk; and has served on the speakers’ bureau of AstraZeneca, Boehringer Ingelheim, Eli Lilly & Co., Menarini/Berlin Chemie, Merck, Sharp & Dohme, and Novo Nordisk. WKO reports serving as a consultant to Astellas, AstraZeneca, Bayer, Janssen, Sanofi and Sema4 and has recently taken a role as Chief Medical Science Officer for Sema4. AER is a member of the advisory board for Rhythm Pharmaceuticals, Inc. and REWIND Co. CWlR reports serving on advisory boards and receiving honoraria for speaker meetings from Novo Nordisk, GI Dynamics, Johnson & Johnson, Herbalife, Boehringer Ingelheim, Sanofi, Keyron and AnBio and has received funding from the EU Innovative Medicine Initiative, Science Foundation Ireland, Health Research Board, Irish Research Council, Swedish Research Council and European Foundation for Study of Diabetes. FR reports receiving research grants from Ethicon and Medtronic and consulting fees from Ethicon, Novo Nordisk, and Medtronic and is on the scientific advisory board of GI Dynamics and Keyron. PS received grant support from Ethicon, Medtronic and Pacira and serves as a consultant for Ethicon, Medtronic, GI Dynamics, Persona, Keyron, Mediflix, SE LLC and Medscape. RT reports lecture fees from Lilly and Novartis and consultancy fees from Wilmington Healthcare and is author of the book Life Without Diabetes. DT declares no personal conflict of interest but has permanent employment with Diabetes UK, who has commercial relationships with various pharmaceutical and food companies. All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Publisher Copyright: © 2021, Endocrine Society, European Association for the Study of Diabetes, Diabetes UK, and American Diabetes Association. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often due to newer forms of treatment. However, terminology for describing this process and objective measures for defining it are not well established, and the long-term risks vs benefits of its attainment are not well understood. To update prior discussions of this issue, an international expert group was convened by the American Diabetes Association to propose nomenclature and principles for data collection and analysis, with the goal of establishing a base of information to support future clinical guidance. This group proposed ‘remission’ as the most appropriate descriptive term, and HbA1c <48 mmol/mol (6.5%) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion. The group also made suggestions for active observation of individuals experiencing a remission and discussed further questions and unmet needs regarding predictors and outcomes of remission.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454