Type 2 Diabetes Remission: A systematic review and meta-analysis of non-surgical randomised controlled trials

<p dir="ltr">Background: Evidence that type 2 diabetes can be reversed has been limited by the understanding and implementation of these interventions. </p><p dir="ltr">Purpose: Assessed the effect of non-surgical randomized controlled trials (RCTs) on type 2 diabetes remission and characterized core components.</p><p dir="ltr">Data Sources: Systematic review of MEDLINE and EMBASE (inception to April 2025).</p><p dir="ltr">Study Selection: RCTs of multi-modal pharmacological or non-pharmacological type 2 diabetes remission interventions for adults with type 2 diabetes.</p><p dir="ltr">Data Extraction: Study characteristics and clinical/population health, patient-reported, and adverse event outcomes.</p><p dir="ltr">Data Synthesis: We performed a random effects multi-level meta−analysis of studies grouped based on type of intervention and by length of follow-up. Eighteen studies were included in this review from 11 different countries. There was a higher likelihood of achieving type 2 diabetes remission through multi-modal interventions [RR 1.75 (95% CI, 1.49 to 2.04)] and for non-pharmacological interventions [RR 5.80 (95% CI, 4.28 to 7.87)], compared to the control group. Other significant outcomes for intervention groups compared to control groups included change in A1C, weight loss, quality of life, and improvements in adverse events of hypoglycemia. </p><p dir="ltr">Limitations: Heterogeneity in our small pool of included studies (diversity of non-pharmacological components), stringent intervention protocols, narrow participant selection criteria, and lack of consistent diabetes remission definitions.</p><p dir="ltr">Conclusions: With specific protocols, a variety of tailored approaches can induce type 2 diabetes remission for patients with newly diagnosed type 2 diabetes who are able to subscribe to strict protocols. Future research needs to consider long term sustainability and effectiveness, along with patient preferences.</p><p><br></p>