What’s in a Name? Redefining Type 2 Diabetes Remission

Kalra, Sanjay; Singal, Arbinder; Lathia, Tejal

doi:10.1007/s13300-020-00990-z

Cited by 15 publications

(19 citation statements)

References 14 publications

(19 reference statements)

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“…Here, we believe that patients whose syndromes do not deteriorate after taking Chinese herbs, to some extent, demonstrate the effectiveness of TCM or at least prove that TCM is beneficial in keeping their condition stable. For this chronic disease, portraying "cure of diabetes" as a goal for all persons with diabetes, however, is misleading and has the potential to do harm [39]. Even for insulin, it is not a cure for diabetes; it is just a treatment [40].…”

Section: Discussionmentioning

confidence: 99%

Study on the TCM Syndromes Evolution and Chinese Herbal Characteristics of Type 2 Diabetes Patients with Different Courses of Disease in TCM “Heat Stage”: A Real-World Study

Xing

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. The purpose of this study is to analyze and summarize the syndrome distribution, syndrome evolution, and Chinese herb medicine characteristics of T2D in heat stage. Method. In this study, 228 heat-stage T2D patients were divided into three groups based on the course of disease. Group 1 (the course of disease ≤5 years) included 118 patients. Group 2 (5< the course of disease ≤10 years) had 73 patients. Group 3 (the course of disease >10 years) consisted of 37 patients. The main methods used in our study were complex network community partitioning algorithms and Sankey diagram visualization, based on the clinical electronic medical record data we collected. Result. In the three groups, the nodes with the highest node degree are all “heat syndrome.” Edge weight between “heat” and “dampness,” “qi stagnation,” “phlegm,” “liver,” and “stomach” is the largest. During the whole course of treatment, 60.17%, 63.01%, and 62.16% of the patients’ syndromes in groups 1, 2, and 3, respectively, were ascribed to the heat stage all the time. The patients’ syndromes in groups 1 and 2 easily transformed to the syndrome of deficiency of both qi and yin of the spleen and stomach. In group 3, 27% of the patients’ syndromes were easily transformed into kidney yin deficiency and qi deficiency and blood stasis syndrome. The largest Chinese herb communities of the patients whose syndromes did not change after treatment in the three groups were all heat-clearing drugs. The proportion of blood-activating drugs in patients with syndrome changes increased significantly after treatment. Conclusion. (1) The basic syndrome of T2D patients in the heat stage is liver-stomach heat syndrome. (2) T2D patients in the heat stage tend to deteriorate towards the direction of qi and yin deficiency syndrome. However, the longer the course of the disease is, the more likely it is to deteriorate to the direction of kidney yin deficiency syndrome and blood stasis syndrome. (3) Drugs that can help T2D patients in the heat stage to maintain their condition stably are heat-clearing drugs represented by Coptis chinensis, which usually need to be combined with warming interior drugs such as Zingiberis Rhizoma and Pinelliae Rhizoma.

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Section: Discussionmentioning

confidence: 99%

Study on the TCM Syndromes Evolution and Chinese Herbal Characteristics of Type 2 Diabetes Patients with Different Courses of Disease in TCM “Heat Stage”: A Real-World Study

Xing

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…To understand the concept of T2DM remission, it is essential to have an appropriate and clear definition [12]. The first definition of T2DM remission was proposed by Buse et al in 2009, stating that remission is the achievement of a glycemic level below the diabetic range, in the absence of any pharmacologic or surgical therapy [16].…”

Section: Defining T2dm Remissionmentioning

confidence: 99%

“…Recently, the categorization of diabetes remission has been based on metabolic, clinical biochemical, and pharmacologic parameters [12]:…”

Section: Levels Of T2dm Remissionmentioning

confidence: 99%

“…Therefore, the term “cure” is currently not applicable to T2DM, as it has been well documented that the condition has the potential for recurrence [ 11 ]. Therefore, it would be misleading to portray the “cure of diabetes” as a treatment goal for individuals with diabetes [ 12 ].…”

Section: Diabetes: Preventable Curable or Both?mentioning

confidence: 99%

“…In the available literature, “diabetes reversal” is used almost synonymously with “diabetes remission” [ 11 ]. The reversal of the parameters of diabetes, such as hyperglycemia, is termed as “diabetes remission” [ 12 ]. Although both the terms “remission” and “reversal” are commonly used in the field of diabetes care, recent consensus supports the use of “remission” in the context of T2DM [ 10 , 12 ].…”

Section: Reversal and Remission Of T2dm: Are They Synonymous?mentioning

confidence: 99%

See 2 more Smart Citations

Quantifying Remission Probability in Type 2 Diabetes Mellitus

Kalra

Bantwal

Kapoor

et al. 2021

Clinics and Practice

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Type 2 diabetes mellitus (T2DM) is a chronic progressive disorder and is associated with significant morbidity and mortality. The concept of T2DM remission and the reversal of diabetic parameters to normal levels has been gaining momentum over the past years. T2DM remission is increasingly being recognized by various global guidelines. Multiple models have been developed and validated for quantifying the extent of remission achieved. Based on favorable clinical evidence, T2DM remission can be considered as the therapeutic goal in diabetes management and, in select cases, as an alternative to expensive treatment options, which can be burdensome as T2DM progresses. This narrative review discusses the available strategies, such as lifestyle interventions, physical activity, bariatric surgery, medical nutrition therapy, and non-insulin glucose-lowering medications, for achieving T2DM remission. Although the concept of T2DM remission has emerged as a real-world option, effective implementation in routine clinical practice may not be feasible until long-term studies prove the efficacy of different approaches in this regard.

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