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. 2025 Jan 22;24(1):37.
doi: 10.1186/s12933-025-02578-y.

Impact of diabetes remission or progression on the incidence of cardiovascular disease in Japan: historical cohort study using a nationwide claims database

Chihiro Shimayama  1   2 , Kazuya Fujihara  3 , Laymon Khin  1 , Hiroki Takizawa  1 , Chika Horikawa  1   4 , Takaaki Sato  1 , Masaru Kitazawa  1 , Yasuhiro Matsubayashi  1 , Takaho Yamada  1 , Hirohito Sone  1
Affiliations

Impact of diabetes remission or progression on the incidence of cardiovascular disease in Japan: historical cohort study using a nationwide claims database

Chihiro Shimayama et al. Cardiovasc Diabetol. .

Abstract

Background: Previous studies demonstrated that diabetes remission can occur during intensive intervention and in real-world settings. However, the impact of diabetes remission in real-world settings on the incidence of cardiovascular disease (CVD) remains unclear.

Methods: This retrospective cohort study included 299,967 individuals aged 20-72 years who underwent multiple checkups between 2008 and 2020 and completed ≥ 3 years of follow-up. Patients were divided into four groups according to changes in glycated hemoglobin levels and the use of diabetes medications during the 1-year baseline period: diabetes mellitus (DM)+/no remission, DM+/remission, DM-/no progression, and DM-/progression. The risk of CVD was evaluated using multivariable Cox regression analysis.

Results: The median follow-up period was 5.0 years. The rates of CVD in the DM+/no remission, DM+/remission, DM-/no progression, and DM-/progression groups were 7.96, 4.76, 1.99, and 5.47 per 1000 person-years, respectively. Compared with DM+/no remission, DM+/remission reduced the risk of CVD [hazard ratio (HR) = 0.71, 95% confidence interval (CI) = 0.57-0.89]. Meanwhile, the HR for CVD in the DM+/remission group was 0.75 (95% CI = 0.56-0.99) for change in BMI ≤ 0%, versus 0.66 (95% CI = 0.45-0.96) for change in BMI > 0%.

Conclusions: In a real-world setting without intensive intervention, diabetes remission decreased the risk of CVD by approximately 30% regardless of changes in BMI, suggesting that diabetes remission can prevent CVD without weight loss in routine care and emphasizing the importance of achieving remission.

Keywords: Cardiovascular disease; Epidemiology; Real-world setting; Remission; Type 2 diabetes.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Ethics Committee of Niigata University approved this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for the cumulative incidence of CVD, CAD, or stroke according to changes in the diabetes status. (A) All participants, (B) DM+ group (participants with type 2 diabetes at the first checkup), (C) DM−group (participants without type 2 diabetes at the first checkup). CVD was defined as composite of CAD and stroke. CVD, cardiovascular disease; CAD, coronary artery disease; DM, diabetes mellitus
Fig. 2
Fig. 2
Hazard ratios of CVD according to the diabetes remission status stratified by age, baseline BMI, or changes in the BMI subgroup. The Cox proportional hazards regression model was adjusted for age, sex, body mass index, systolic blood pressure, low density lipoprotein cholesterol, high density lipoprotein cholesterol, smoking, antihypertensive drug and lipid-lowering drug usage, and the reference (1.0) was the DM+/no remission group. CVD, cardiovascular disease; BMI, body mass index; HR, hazard ratio
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References

    1. Riddle MC, Cefalu WT, Evans PH, Gerstein HC, Nauck MA, Oh WK, Rothberg AE, le Roux CW, Rubino F, Schauer P, et al. Consensus report: definition and interpretation of remission in type 2 diabetes. Diabetes Care. 2021;44(10):2438–44. - PMC - PubMed
    1. Taheri S. Type 2 diabetes remission: a new mission in diabetes care. Diabetes Care. 2024;47(1):47–9. - PubMed
    1. Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE, Thomas S, Abood B, Nissen SE, Bhatt DL. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76. - PMC - PubMed
    1. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, Navaneethan SD, Singh RP, Pothier CE, Nissen SE, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376(7):641–51. - PMC - PubMed
    1. Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Capristo E, Chamseddine G, Bornstein SR, Rubino F. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2021;397(10271):293–304. - PubMed

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