Non-insulin Hypoglycemic Drugs in Type 2 Diabetes Remission

The prevalence of type 2 diabetes mellitus (T2DM) is increasing, and diabetes remission can set patients free from hypoglycemic medications for a long time, delay disease progression, and reduce the risk of complications. The 2021 ADA consensus statement updated the recommended definition of diabetes remission as HbA1c < 6.5% for at least three months after discontinuation. If there are factors affecting the accuracy of HbA1c detection, the average HbA1 < 6.5% estimated by continuous blood glucose monitor or fasting blood glucose <7.0 mmol/L can be used as a surrogate indicator. There is clear evidence that intensive lifestyle management, metabolic or bariatric surgery, and short term intensive insulin therapy (SIIT) can help patients reach diabetes remission. Although metabolic surgery is effective in weight loss and diabetes remission, there is a risk of postoperative complications. Weight management requires good compliance and rigorous control. SIIT requires continuous insulin injections to keep blood glucose within the normal level, which is at risk of hypoglycemic events. Recent researches support that non-insulin hypoglycemic drugs also effective in diabetes remission. For example, SGLT2 and GLP1 have certain weight loss and significant hypoglycemic effects, which may achieve diabetes remission through weight loss. Non-insulin hypoglycemic drugs are less prone to hypoglycemia events and will not cause postoperative complications. However, there are few studies evaluating the efficacy of the non-insulin hypoglycemic drugs and comparing the three previous treatments to achieve diabetes remission.

This Research Topic focuses on the role of non-insulin hypoglycemic drugs in diabetes remission, especially GLP‐1RA and SGLT2i. And we welcome submissions analyzing the effect of moderators on changes in BMI, Hb1Ac, duration of remission, prognosis, etc. Besides, we are interested in different ways to achieve diabetes remission, especially with non-insulin hypoglycemic drugs. Clinical evidence and investigation of underlying mechanisms are encouraged.

We welcome Original Research, Systematic Reviews, Reviews, and Clinical Trial papers regarding the following sub-topics, including but not limited to:
• Non-insulin hypoglycemic drugs to reach diabetes remission
• Comparison of different treatments for diabetes, on condition, outcome, duration, complications, etc.
• Underlying mechanisms of different ways to achieve diabetes remission