Regression to mean accounts for many remissions from apparent type 2 diabetes
medwireNews: A large number of people diagnosed with type 2 diabetes achieve intermediate or even normal glucose levels within the following few years, with regression to the mean accounting for more than half of these remissions, research suggests.
Writing in Diabetes Care, Maria Inês Schmidt (Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil) and study co-authors therefore emphasize the importance of repeating glucose tests in people thought to have diabetes.
“Although clinicians in busy day-to-day practice may skip confirmation, our findings illustrate that lack of confirmation will result in a large proportion of individuals receiving pharmacological treatment who do not really have diabetes,” they say.
The team identified 526 people, from 11,645 participants of the ELSA-Brasil longitudinal cohort study, who were newly diagnosed with type 2 diabetes on the basis of oral glucose tolerance testing and glycated hemoglobin level.
When repeated after an average of 3.84 years, 49.4% of these people had regressed, mostly to intermediate hyperglycemia, although 4.9% had normoglycemia. But regression to the mean accounted for more than half of this – after adjusting for this effect, the proportion who regressed was a considerably smaller 20.2%.
Some of this remaining proportion was accounted for by improvements in glucose homeostasis (indicated by the disposition index) and by weight loss.
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