The international consensus definition of type 2 diabetes remission is an HbA1c below 6.5% measured at least three months after stopping all glucose-lowering medication. A low HbA1c on metformin, or a GLP-1 receptor agonist taken for weight, is control, not remission.
Remission is not cure. People in remission still need at least yearly HbA1c checks, and retinal, kidney and foot screening should continue, because relapse is common and complications already established do not reverse.
- Confirm HbA1c below 6.5% at least three months after the last glucose-lowering drug.
- Record 'type 2 diabetes in remission' rather than removing the diagnosis.
- Keep annual HbA1c, retinal, kidney and foot checks going.
- Tell patients relapse is common and what to watch for.
Why it matters
Patients in remission are often discharged from screening, and that is when retinopathy and kidney disease go unseen.
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