Kim Jinyoung, Kwon Hyuk-Sang
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Diabetes Metab J. 2022 Mar;46(2):165-180. doi: 10.4093/dmj.2021.0377. Epub 2022 Mar 24.
A durable normoglycemic state was observed in several studies that treated type 2 diabetes mellitus (T2DM) patients through metabolic surgery, intensive therapeutic intervention, or significant lifestyle modification, and it was confirmed that the functional β-cell mass was also restored to a normal level. Therefore, expert consensus introduced the concept of remission as a common term to express this phenomenon in 2009. Throughout this article, we introduce the recently updated consensus statement on the remission of T2DM in 2021 and share our perspective on the remission of diabetes. There is a need for more research on remission in Korea as well as in Western countries. Remission appears to be prompted by proactive treatment for hyperglycemia and significant weight loss prior to irreversible β-cell changes. T2DM is not a diagnosis for vulnerable individuals to helplessly accept. We attempt to explain how remission of T2DM can be achieved through a personalized approach. It may be necessary to change the concept of T2DM towards that of an urgent condition that requires rapid intervention rather than a chronic, progressive disease. We must grasp this paradigm shift in our understanding of T2DM for the benefit of our patients as endocrine experts.
在多项通过代谢手术、强化治疗干预或显著生活方式改变来治疗2型糖尿病(T2DM)患者的研究中,观察到了持久的血糖正常状态,并且证实功能性β细胞量也恢复到了正常水平。因此,专家共识在2009年引入了缓解这一通用术语来表述这一现象。在本文中,我们介绍了2021年关于T2DM缓解的最新共识声明,并分享我们对糖尿病缓解的看法。在韩国以及西方国家,都需要对缓解进行更多研究。缓解似乎是由对高血糖的积极治疗以及在β细胞发生不可逆变化之前的显著体重减轻所促成的。T2DM并非是让易患病个体无奈接受的诊断。我们试图解释如何通过个性化方法实现T2DM的缓解。可能有必要将T2DM的概念转变为一种需要快速干预的紧急状况,而非一种慢性、进行性疾病。作为内分泌专家,为了我们患者的利益,我们必须在对T2DM的理解中把握这一范式转变。