Riddle Matthew C, Cefalu William T, Evans Philip H, Gerstein Hertzel C, Nauck Michael A, Oh William K, Rothberg Amy E, le Roux Carel W, Rubino Francesco, Schauer Philip, Taylor Roy, Twenefour Douglas
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.
J Clin Endocrinol Metab. 2022 Jan 1;107(1):1-9. doi: 10.1210/clinem/dgab585.
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 versus 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 HbA1c < 6.5% (48 mmol/mol) 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.
部分糖尿病患者的血糖水平可改善至正常范围，这可能是自发出现的，也可能是在医学干预之后出现的，而且在某些情况下，在停用降糖药物治疗后仍可持续。由于有了更新的治疗方式，现在这种持续改善可能更常出现。然而，描述这一过程的术语以及定义它的客观指标尚未确立，而且实现这一目标的长期风险与益处也未得到充分了解。为更新此前关于该问题的讨论，美国糖尿病协会召集了一个国际专家小组，以提出数据收集与分析的命名法和原则，目标是建立一个信息库，为未来的临床指导提供支持。该小组提议将“缓解”作为最合适的描述性术语，并将在停用降糖药物治疗至少3个月后测得的糖化血红蛋白（HbA1c）<6.5%（48 mmol/mol）作为通常的诊断标准。该小组还对处于缓解期的个体进行主动观察提出了建议，并讨论了关于缓解的预测因素和结果的进一步问题及未满足的需求。
