Kim Jinyoung, Kim Bongseong, Kim Mee Kyoung, Baek Ki-Hyun, Song Ki-Ho, Han Kyungdo, Kwon Hyuk-Sang
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2025 Feb 24;40(7):e24. doi: 10.3346/jkms.2025.40.e24.
Lifestyle-related factors have been studied as a fundamental aspect in the onset and progression of type 2 diabetes mellitus. However, behavioral factors are easily overlooked in clinical practice. This study investigated whether lifestyle changes were associated with diabetes remission in newly diagnosed type 2 diabetes patients.
We enrolled patients with new-onset type 2 diabetes from 2009 to 2012 using a health examination cohort from the Korean National Health Insurance Service (KNHIS). Remission was defined as a fasting glucose level less than 126 mg/dL at least once during a health examination after stopping medication. A self-administered questionnaire was used to investigate patients' lifestyles. We investigated smoking, alcohol consumption, and regular exercise before and after starting diabetes medication and the odds ratios (ORs) of logistic regression on remission to evaluate the associations.
A total of 138,211 patients diagnosed with type 2 diabetes from 2009 to 2012 were analyzed, and 8,192 (6.3%) reported remission during the follow-up period to 2017. Baseline fasting blood glucose level measured before starting diabetes medication was significantly higher in the non-remission group (180 mg/dL vs. 159 mg/dL, < 0.001). In addition, the use rate of combined oral hypoglycemic agent treatment was higher in the non-remission group (15% vs. 8%, < 0.001). Consistent smoking and drinking showed negative associations with remission (OR, 0.72; 95% confidence interval [CI], 0.67-0.77 and OR, 0.90; 95% CI, 0.84-0.95, respectively), and initiation of regular exercise presented a positive association with remission (OR, 1.54; 95% CI, 0.46-1.63). Abstinence from alcohol increased the likelihood of remission in the male population (OR, 1.20; 95% CI, 1.10-1.32). The association with smoking history or smoking cessation was not clear, but new smoking behavior interfered with remission in women (OR, 0.48; 95% CI, 0.28-0.81).
We confirmed associations between a healthy lifestyle and diabetic remission in new-onset type 2 diabetes patients. The results of this study suggest that improving lifestyle after diabetes diagnosis may contribute to disease remission.
生活方式相关因素已被作为2型糖尿病发病和进展的一个基本方面进行研究。然而，行为因素在临床实践中很容易被忽视。本研究调查了生活方式的改变是否与新诊断的2型糖尿病患者的糖尿病缓解相关。
我们使用韩国国民健康保险服务（KNHIS）的健康检查队列，纳入了2009年至2012年新诊断的2型糖尿病患者。缓解被定义为在停药后的一次健康检查中，空腹血糖水平至少有一次低于126mg/dL。使用一份自填式问卷来调查患者的生活方式。我们调查了开始糖尿病药物治疗前后的吸烟、饮酒和规律运动情况，以及缓解的逻辑回归比值比（OR），以评估其相关性。
对2009年至2012年诊断为2型糖尿病的138211名患者进行了分析，在随访至2017年期间，有8192名（6.3%）报告缓解。未缓解组在开始糖尿病药物治疗前测量的基线空腹血糖水平显著更高（180mg/dL对159mg/dL，<0.001）。此外，未缓解组联合口服降糖药治疗的使用率更高（15%对8%，<0.001）。持续吸烟和饮酒与缓解呈负相关（OR分别为0.72；95%置信区间[CI]，0.67 - 0.77和OR为0.90；95%CI，0.84 - 0.95），开始规律运动与缓解呈正相关（OR为1.54；95%CI，0.46 - 1.63）。戒酒增加了男性人群缓解的可能性（OR为1.20；95%CI，1.10 - 1.32）。与吸烟史或戒烟的相关性不明确，但新的吸烟行为会干扰女性的缓解（OR为0.48；95%CI，0.28 - 0.81）。
我们证实了新诊断的2型糖尿病患者健康生活方式与糖尿病缓解之间的关联。本研究结果表明，糖尿病诊断后改善生活方式可能有助于疾病缓解。
