Division of Endocrinology, Diabetes, & Clinical Nutrition, Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Diabetologia. 2021 Nov;64(11):2359-2366. doi: 10.1007/s00125-021-05542-z. Epub 2021 Aug 30.
Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often due to newer forms of treatment. However, terminology for describing this process and objective measures for defining it are not well established, and the long-term risks vs benefits of its attainment are not well understood. To update prior discussions of this issue, an international expert group was convened by the American Diabetes Association to propose nomenclature and principles for data collection and analysis, with the goal of establishing a base of information to support future clinical guidance. This group proposed 'remission' as the most appropriate descriptive term, and HbA <48 mmol/mol (6.5%) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion. The group also made suggestions for active observation of individuals experiencing a remission and discussed further questions and unmet needs regarding predictors and outcomes of remission.
改善血糖水平到正常范围可能会在一些患有糖尿病的人身上自发发生，或者在医疗干预后发生，并且在某些情况下，在停止降低血糖的药物治疗后仍然存在。由于新的治疗形式，这种持续的改善现在可能更常见。然而，用于描述这个过程的术语和定义它的客观标准尚未得到很好的建立，并且对其获得的长期风险与益处也了解不足。为了更新之前对这个问题的讨论，美国糖尿病协会召集了一个国际专家组，提出了数据收集和分析的命名法和原则，旨在建立一个信息基础，以支持未来的临床指导。该小组提出“缓解”作为最合适的描述性术语，并建议将停止降低血糖的药物治疗至少 3 个月后测量的 HbA <48 mmol/mol（6.5%）作为常用的诊断标准。该小组还对正在经历缓解的个体进行积极观察提出了建议，并讨论了缓解的预测因素和结果方面的其他问题和未满足的需求。
