N = 117,048. Our findings provide a useful basis for the evaluation of the multifactorial approaches to both remission and prevention of diabetes that are currently being introduced and also highlight the need for guidelines to support definition of remission, management, and follow-up of people that achieve remission. The research states the increase will be driven by the world's ever . It was established during 2010-13 and involved 6,127 participants, aged 16 years and older, from across 12 Scottish NHS Health Boards. Three sensitivity analyses for estimates of the prevalence of remission were carried out. They found a cumulative incidence of achieving remission over 7 years (1.60% [95% CI 1.53 to 1.68]) [20]. BMJ Open. Mireille Captieux, Remission was positively associated with weight loss. The Scottish Diabetes Research Network (SDRN) was commissioned in 2006 by the Chief Scientist Office ( CSO) of the Scottish Government to improve the quality and increase the quantity of diabetes research in Scotland, as part of the UK Clinical Research Collaboration ( UKCRC ). Clinical and metabolic features of the randomised controlled Diabetes Remission Clinical Trial (DiRECT) cohort. Duration was not significantly associated with remission in our study. We visit research labs at University of Edinburgh | Diabetes UK Edinburgh. Cohort Profile: Scottish Diabetes Research Network Type 1 Bioresource Study (SDRNT1BIO). In this study, we found that 4.8% of people with type 2 diabetes who had at least 1 HbA1c 48 mmol/mol (6.5%) after diagnosis of diabetes and had at least 1 HbA1c recorded in 2019 had evidence of type 2 diabetes remission. ORs for remission of type 2 diabetes (95% CI) in Scotland 2019 derived, MeSH Affiliations 1Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK. The .gov means its official. RL has served on advisory boards with Novo Nordisk, Lily and Servier only NS has consulted for Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, and Sanofi, and received grant support from Boehringer Ingelheim, Novartis and Roche, outside the submitted work. Prescription data were defined using Read Codes, the clinical terminology system widely used in UK general practice. N = 152 934 (multiple imputation) and N = 110,814 (CCA). Diabetes research (Edinburgh, Scotland) We conducted a randomised controlled trial (RCT) involving recruitment of 320 people who had diabetes and high blood pressure: 160 continued receiving usual care and the other 160 were given a glucometer and a blood pressure monitor to use at home, which transmitted readings via a modem to a secure website which could be accessed by themselves a. What is Endocrinology? Robert Lindsay, The NHS Research Scotland . The details of individual studies which are currently recruiting participants are listed here. Karter and colleagues also found shorter duration of diabetes to be associated with incidence of remission in their cohort study because incidence studies are better suited to identifying the effect of shorter duration on remission than cross-sectional studies. Drivers for the global rise in diabetes prevalence include increasing numbers of people aged >65 years of age; urbanisation; increasing prevalence of obesity; and improved survival of people with diabetes [2,3]. Recognised body which has been In order to manage this issue, we included only people who recorded an HbA1c in the diabetes range (48 mmol/mol) at some point from diagnosis to 2019, accepting that a proportion of these people may have been initially diagnosed on the basis of fasting plasma glucose (FPG) or two-hour plasma glucose (2-hr PG) alone (although they all subsequently went on to record HbA1c readings 48 mmol/mol). 1 Adjusted for all variables in the model (listed in first column of the table). We identified diagnostic codes for severe comorbidity that could cause weight loss including previous diagnosis of dementia, end-stage kidney disease, liver cirrhosis, metastatic cancer, and cancer (excluding nonmelanoma skin cancer) with a 5-year look-back period applied to both metastatic cancer and cancer diagnoses (see S3 Table). Women had greater median weight loss than men in most age groups with the exception of >75 year olds, for whom men who attained remission had greater median weight loss than women who attained remission (S3 Fig). The prevalence estimates are influenced by our definition of type 2 diabetes remission. Diabetes research (Edinburgh, Scotland) Share on Twitter. The SDRNT1BIO is a research collaboration involving researchers, clinicians and people with diabetes. Finally, we may have underestimated the proportion of people who had received bariatric surgery as we did not have access to data on procedures performed in private hospitals, but bariatric surgery is relatively uncommon in the UK. BMI at diagnosis was categorised into 5 groups based on a simplified World Health Organization (WHO) classification: <18.5 kg/m2; 18.5 to 24 kg/m2; 25 to 29 kg/m2, 30 to 34 kg/m2; 35 to 39 kg/m2; and 40 kg/m2. 2017 Feb 27;2(2):CD009966. Remission of type 2 diabetes was assessed between January 1, 2019 and December 31, 2019. Find out about groups, events and initiatives in your area, and read about opportunities to consider, from fundraising to volunteering. Biomarkers associated with progression of renal disease in type 1 diabetes. In the early 1990s, remission was demonstrated in people with type 2 diabetes after bariatric surgery [9]. Diabetic Medicine RESEARCH ARTICLE Open Access Type 1 diabetes incidence in Scotland between 2006 and 2019 India Thomson, Niall Anderson, Louise Bath, Sarah Kiff, Chris Patterson, Sam Philip, Norman Waugh, Sarah H. Wild See all authors First published: 14 February 2023 https://doi.org/10.1111/dme.15069 Read the full text PDF Tools Share Abstract PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US. This nonsurgical approach has the potential to make remission of type 2 diabetes more widely feasible without the adverse long-term effects of bariatric surgery. Careers. STROBE, STROBE, Strengthening The Reporting of OBservational Studies in Epidemiology. S5 Table. Similarities between our findings and Karter and colleagues were that remission of type 2 diabetes was more common in people aged 65 years, people who were not prescribed GLT at diagnosis of diabetes, and people who had a lower HbA1c at diagnosis. National Health Service;NMAR, Taylor R, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Sattar N, Welsh P, Peters C, Zhyzhneuskaya S, Hollingsworth KG, Al-Mrabeh A, Rodrigues AM, Rehackova L, Adamson AJ, Sniehotta FF, Mathers JC, Ross HM, McIlvenna Y, Kean S, Ford I, McConnachie A, Lean MEJ. Median weight change (kg) from diagnosis of type 2 diabetes to 2019 according to remission (n = 7,710) and nonremission status (n = 154,606). The recent finding that type 2 diabetes is independently associated with increased odds of death with Coronavirus Disease 2019 (COVID-19) may further accelerate interest in achieving remission of type 2 diabetes [17]. Long-term remission of type 2 diabetes after very-low-calorie restriction and related predictors. 29 June, 2023 14:43. We defined GLT as any combination of metformin, sulphonylureas, thiazolidinediones, dipeptidyl peptidase 4 (DPP-4) inhibitors, sodium glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 receptor (GLP-1) agonists, and insulin. HbA1c <48 mmol/mol (6.5%) or FPG <7.0 mmol/l (126mg/dL) on two occasions separated by six months; 3. doi: 10.1371/journal.pmed.1002985. Shareen Forbes (MBChB, PhD, FRCP) | The University of Edinburgh . Coronavirus Disease 2019;DiRECT, Position statements or recommendations for practice have been published by the Primary Care Diabetes Society (PCDS) [4], the International Diabetes Federation (IDF) [5], and a multidisciplinary group of experts [6] in 2019, 2017, and 2009, respectively. S4 Table. The . This page doesn't seem to exist. Action for Health in Diabetes;AIC, Weight change was defined as the value recorded in 2019 subtracted from the value recorded closest to diagnosis of diabetes. The University of Edinburgh, Western General Hospital Crewe Road South Edinburgh EH4 2XU . Flow diagram showing the number of individuals with type 2 diabetes diagnosed in, Fig 2. Diabetes research (Edinburgh, Scotland) Publications The influence of insulin and sorbinil on myo-inositol uptake in peripheral nerve from normal and diabetic rats and a neuroblastoma cell line. Scottish Intercollegiate Guidelines Network;SIMD, Type 1 diabetes incidence in Scotland between 2006 and 2019 Our results suggest that supporting clinicians to discuss remission and to refer to weight management services with early or diet-controlled diabetes is a rational approach. There is a sizeable proportion of people who achieve remission of type 2 diabetes outside research trials and without bariatric surgery. We have previously shown that there were at least 96 unique definitions of diabetes remission used in the research literature from 2009 to 2020 [8]. They also excluded people who had bariatric surgery, and end of follow-up was December 31, 2011, prior to wider interest in the use of very low calorie diets to achieve remission of diabetes. Second, inclusion of the 9,219 patients who had never had an HbA1c 48 mmol/mol in both numerator and denominators meant that estimated prevalence of diabetes remission in the 171,535 patients with at least 1 HbA1c in 2019 was 9.9% (95% CI 9.7 to 10.0). Scottish Index of Multiple Deprivation;STROBE, There were an estimated 463 million people with diabetes in the world in 2019, of whom 90% to 95% have type 2 diabetes [1]. Freedom of information publication Primary Care Diabetes Society;SCI-Diabetes, World Health Organization. For news and ways to get involved follow us on Facebook,Twitterand Instagram. However, more data are needed to establish whether a very low calorie diet approach will be effective or appropriate in people that have been excluded from trials. The incidence of diabetes in the anti-asialo GM1 antibody . PMC Sarah H. Wild, 26 June 2023. Associations of serum N-glycans with glycaemic control and albuminuria in type 1 diabetes. Patterns of Glucose and Diabetes Management among Scottish Diabetes Research Network Type 1 Diabetes Bioresource participants. dipeptidyl peptidase 4;DUK, Please enable it to take advantage of the complete set of features! United Kingdom governments have recently included remission of type 2 diabetes in their long-term type 2 diabetes frameworks [14,15], and the American Diabetes Association (ADA) Standards of Medical Care has, for the first time, included guidance on prescribing very low calorie diets to improve glycaemic control and promote remission of diabetes [16]. International Classification of Diseases-10th revision;IDF, Examples of recent key findings include analysis of the incidence and relative risks for COVID-19 infection, drug safety of insulin glargine and SGLT2 inhibitors, life expectancy estimates, evaluation of the impact of flash monitors on glycaemic control and diabetic ketoacidosis and time trend analysis showing that diabetic ketoacidosis (DKA) re. The Scottish Diabetes Research Network (SDRN) is a clinical research network which coordinates and facilitates diabetes research across Scotland. Fig 1 provides a description of the cohort selection for different aspects of the analysis. PDF Edinburgh Research Explorer - The University of Edinburgh The mean (SD) HbA1c at follow-up was 63.0 (15.5) mmol/mol in the intervention group and 67.8 (14.7) mmol/mol in the usual care group. Unless explicitly stated otherwise, all material is copyright The University of Edinburgh 2023. Multivariable analyses using complete case analyses showed similar results to the analyses using imputed data (S5 and S6 Tables, S4 and S5 Figs). Aims/hypothesis. government site. Further research is needed to investigate the association between remission and complications of diabetes including mortality. Supported Telemonitoring and Glycemic Control in People with Type 2 Diabetes: The Telescot Diabetes Pragmatic Multicenter Randomized Controlled Trial, Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes, Freedom of information publication scheme. The study has a number of limitations. A 1-year period was the most commonly used duration in definitions of remission (30% of definitions published in the research literature since 2009) [8]. eCollection 2019 Nov. Whittaker E, Read SH, Colhoun HM, Lindsay RS, McGurnaghan S, McKnight JA, Sattar N, Wild SH; Scottish Diabetes Research Network Epidemiology Group. -, Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. This site needs JavaScript to work properly. We defined remission as all HbA1c values <48 mmol/mol in the absence of glucose-lowering therapy (GLT) for a continuous duration of 365 days before the date of the last recorded HbA1c in 2019. In secondary analysis, there was a greater number of telephone calls between practice nurses and patients in the intervention compared with control group (rate ratio 7.50 (95% CI 4.4512.65. Clipboard, Search History, and several other advanced features are temporarily unavailable. The current research projects in 2017-18 are: Glycaemia Trajectories in Type 1 Diabetes and their Association with Complications (Diabetes UK funded) Harnessing genetic information in the SDRNT1BIO to understand Type 1 diabetes and its complications (Diabetes UK funded) Extreme Phenotypes Relevant to Diabetic Complications in Type 1 Diabetes .
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