Short-term studies have shown that remission of type 2 diabetes can be achieved without drug therapy or surgery, but these studies have involved intensive weight loss interventions in selected populations. Using data from a population-based study, researchers quantified the association between behavior change and weight loss in the year after diabetes diagnosis and the subsequent four years, as well as the likelihood of remission at five-year follow-up.

People 40 to 69 years old from 49 general practices in England were invited to participate in a type 2 diabetes screening program. The 867 participants in whom diabetes was identified were randomized into either the intervention group, which received multifactorial treatment, or a control group that received routine care, following current UK national guidelines for diabetes management.

Remission, defined as a glycated hemoglobin level of less than 48 mmol/mol (6.5%) without diabetes medication or bariatric surgery, was achieved in 257 participants. Patients who lost 10% or more of body weight in the first year after diagnosis were significantly more likely to achieve remission at five years than those whose weight increased or remained stable. Similar trends were observed between one and five years of follow-up. The greater the weight loss, the higher the likelihood of remission. No consistent associations were observed between changes in health behaviors and remission.

The authors point out that this study, which involved patients in routine clinical care, didn't require specific dietary restrictions or physical activity interventions. The results, therefore, are generalizable to wider populations of patients with diabetes. However, because the study cohort wasn't ethnically diverse-it included mostly white Europeans-these findings need to be replicated in more diverse populations.