Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 19;4(3):e00280.
doi: 10.1002/edm2.280. eCollection 2021 Jul.

Association of type 2 diabetes remission and risk of cardiovascular disease in pre-defined subgroups

Hilda Hounkpatin  1   2 , Beth Stuart  2 , Andrew Farmer  3 , Hajira Dambha-Miller  2
Affiliations

Association of type 2 diabetes remission and risk of cardiovascular disease in pre-defined subgroups

Hilda Hounkpatin et al. Endocrinol Diabetes Metab. .

Abstract

Aim: To quantify the association between type 2 diabetes remission and 5-year incidence of cardiovascular disease outcomes, overall and in pre-defined subgroups.

Methods: Retrospective cohort analysis of 60,287 adults with type 2 diabetes from the Care and Health Information Analytics (CHIA) database. Multivariable Cox models were used to assess the association between remission within the first two years of follow-up and incidence of cardiovascular disease (CVD) outcomes including events, microvascular and macrovascular complications at 7-year follow-up. Effect modification by age, sex, diabetes duration, pre-existing CVD, baseline body mass index (BMI) and HbA1c level was assessed.

Results: 7489 (12.4%) people achieved remission during the first two years of follow-up. Overall, remission was associated with lower risk of CVD outcomes. Remission was associated with lower risk of microvascular complications for younger compared with older age groups (eg aHR: 0.59 (0.41-0.84) and aHR: 0.78 (0.67-0.92) for those aged <45 years and 75-84 years, respectively). Amongst those achieving remission, those with no or 1-2 comorbidities had lower risk of microvascular complications (aHR: 0.65 (0.56-0.75)) compared to those with more than three comorbidities (aHR: 0.83 (0.69-0.99), respectively). There were no significant interactions in the remaining subgroups or for models assessing CVD events or macrovascular complications.

Conclusions: Achieving remission of type 2 diabetes is associated with a lower risk of microvascular complications, particularly for younger groups and those with fewer comorbidities. Targeted interventions that focus on promoting remission in these groups may reduce the impact of microvascular complications and associated health costs.

Keywords: epidemiology; healthcare delivery; lifestyle; macrovascular disease; microvascular disease.

PubMed Disclaimer

Conflict of interest statement

None to declare.

References

    1. International Diabetes Federation . Worldwide toll of diabetes . Diabetes Atlas 2019:9–11. https://www.diabetesatlas.org/en/sections/worldwide‐toll‐of‐diabetes.html. Accessed 1 December 2020.
    1. Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia. 2001;44(Suppl. 2):S14‐S21. - PubMed
    1. Public Health England . Health Matters: Protecting and Improving the Nations’ Health: Action Plan For Cardiovascular Disease Prevention, 2017 to 2018; London, UK: 2017.
    1. Gregg EW, Chen H, Wagenknecht LE, et al. Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA. 2012;308:2489. - PMC - PubMed
    1. Karter AJ, Nundy S, Parker MM, Moffet HH, Huang ES. Incidence of remission in adults with type 2 diabetes: the diabetes & aging study. Diabetes Care. 2014;37(12):3188‐3195. - PMC - PubMed

Publication types