About 1.5 million Americans are diagnosed with diabetes every year. The vast majority of cases (90–95 percent) will be type 2 diabetes, a chronic health condition that can lead to heart disease, kidney disease, vision loss, and more.
For a subset of these patients, it doesn't have to be that way.
A huge amount of research in recent years has demonstrated that type 2 diabetes can be reversed in the body, with a range of dieting methods and other kinds of lifestyle interventions sending the disease into remission.
It is, however, quite hard to know for sure how many people are able to successfully pull off such a reversal. After all, hundreds of millions of people around the world are currently diabetic, but millions of them aren't even aware they have the condition.
Against such a backdrop – and outside of scientific experiments specifically measuring type 2 diabetes remission – it's difficult to say how many people might develop the condition before going on to successfully reverse it.
Nonetheless, a new study from Scotland suggests the phenomenon might be more common than we realized, even without things like scientific interventions and invasive procedures such as bariatric surgery.
"We have been able to show, for the first time, that one in 20 people in Scotland with type 2 diabetes achieves remission," says clinical diabetes researcher Mireille Captieux from the University of Edinburgh.
"This is higher than expected and indicates a need for updated guidelines to support clinicians in recognizing and supporting these individuals."
In their study, Captieux and her co-authors assessed a national Scottish diabetes registry, containing data for over 99.5 percent of people with a diagnosis of the condition in the country.
They identified 162,316 individuals over the age of 30 with type 2 diabetes on the basis of HbA1c (glycated hemoglobin) readings in the diabetic range.
From this cohort, during the study window (the calendar year of 2019), a total of 7,710 people went into remission on the basis of their HbA1c reading dropping below the diabetic range of 48 mmol/mol (6.5 percent), representing approximately 4.8 percent of the group.
Individuals who were more likely to go into remission were older, had lost weight since their diagnosis, had no history of glucose lowering therapy or bariatric surgery, and generally had healthier blood readings at the time of their diagnosis.
"Our prevalence estimates suggest that a reasonably large proportion of people achieve remission of type 2 diabetes in routine clinical care outside trial or bariatric surgery settings," the researchers write in their paper.
"The immediate implications for practice are that these people should be recognized and coded appropriately so they can be given adequate support and followed up to ensure continued care consistent with diabetes management guidelines. It is important to recognize that remission of diabetes may not be permanent."
Beyond helping us to support people who appear to successfully reverse their type 2 diabetes on their own, the findings could go some way to helping researchers and health workers identify which patients might be most likely to achieve and maintain remission.
It's as yet unclear how these results from Scotland might apply to communities elsewhere, but one thing's for sure.
With estimates predicting that today's population of roughly 460 million diabetics worldwide will expand to some 700 million people by 2045, we need plenty more insights on how to turn this disease around, and soon.
The findings are reported in PLOS Medicine.