Diabetes remission lowers risk of cardiovascular disease and chronic kidney disease

Subjects from a weight loss trial who achieved any remission from Type 2 diabetes also achieved a 40% lower rate of cardiovascular disease (CVD) and a 33% lower rate of chronic kidney disease (CKD).

Researchers reported these findings on Jan. 18, 2024 in Diabetologia.

“Participants with type 2 diabetes with evidence of remission had a substantially lower incidence of CKD and CVD, respectively, compared with participants who did not achieve remission,” the authors said. “The magnitude of risk reduction was greatest for participants with evidence of longer-term remission,” they added.

In The Look AHEAD study, the researchers compared the effects of an intensive lifestyle intervention with a diabetes support and education (DSE) intervention  on the incidence of cardiovascular disease and other health problems, including chronic kidney disease.

The study was conducted between 2001 and 2016, and the investigators enrolled and randomized 5,145 adult subjects who were overweight or obese and diagnosed at baseline with type 2 diabetes.

Subjects were 58% female, a mean age of 59 years, a mean duration of diabetes of 6 years and a mean BMI at baseline of 35.8 kg/m² (in the range of severe obesity).

In this post retrospective and comparative analysis of data from the two intervention cohorts, the investigators classified each subject by remission status during follow-up.

They compared the incidence of cardiovascular disease and chronic kidney disease for the two groups of subjects based on achievement and duration of diabetes remission.

The investigators defined remission as discontinuation of diabetes medications and achievement of an HbA1c of <48 mmol/mol (6.5%) at a minimum of one point in time.

The investigators defined high-risk or very high-risk chronic kidney disease using the Kidney Disease Improving Global Outcomes (KDIGO) criteria, and they defined cardiovascular disease incidence as any event of non-fatal acute heart attack, stroke, hospital admission for angina, or cardiovascular disease related death.

They reported that those subjects with any remission during follow-up achieved a 33% lower rate of chronic kidney disease and a 40% lower rate of the composite cardiovascular disease measure

The magnitude of risk reduction was greatest for participants with evidence of long-term remission.

Lead author professor Edward Gregg , Head of the School of Population Health, RCSI (Royal College of Surgeons in Ireland) University of Medicine and Health Sciences in Dublin, said, “As the first intervention study to associate remission with reduction of diabetes-related complications, this is encouraging news for those who can achieve remission from type 2 diabetes. While our study is also a reminder that maintenance of weight loss and remission is difficult, our findings suggest any success with remission is associated with later health benefits.”