AACE MENA 2025-Remission of T2D Through Diet

Video Transcription

Video Summary

The presentation discusses the official recognition of type 2 diabetes remission with new diagnostic codes and explores various approaches to achieve remission, including lifestyle changes, pharmacologic intervention, and surgery. Remission criteria typically require maintaining specific A1C levels below diabetic thresholds without glucose-lowering medications for at least three months. Lifestyle modifications such as Mediterranean diets, intermittent fasting, and low-carbohydrate diets show evidence supporting prevention and remission of diabetes. Retrospective studies reveal remission rates around 3-5%, often higher in early diagnosed cases or with minimal medication usage. The Direct study in the UK demonstrated that significant calorie reduction and weight loss through structured dietary interventions could induce remission, although sustained remission at five years remains challenging. GLP-1 receptor agonists like terzepatide and semaglutide facilitate weight loss and reduce progression to diabetes, but benefits diminish if medication is stopped. Bariatric surgery effectively increases remission rates and reduces long-term complications. Physical activity, especially increased daily steps and moderate-to-intense exercise, lowers diabetes risk and may play a supportive role in remission. Overall, weight loss—even modest—improves remission chances. The presentation emphasizes that remission is possible but requires sustained lifestyle or medical intervention, and patients should be encouraged that developing overt diabetes is not inevitable. Regular monitoring and individualized approaches considering patient preferences and resources are recommended.

Keywords

type 2 diabetes remission

diagnostic codes

lifestyle changes

pharmacologic intervention

bariatric surgery

A1C levels

weight loss

GLP-1 receptor agonists