Prevalence and Predictors of Type 2 Diabetes Remission in a Multidisciplinary Primary Care Program for Patients with Poor Glycemic Control: Role of Weight Change in a Low-Income Mexican Population

Background/Objectives: Type 2 diabetes (T2D) remission can be defined as a return to a HbA1c < 6.5% (<48 mmol/mol) sustained without ongoing treatment for at least 3 months. Prevalence estimates and factors associated remain unknown for LMIC and resource-limited settings. Methods: We conducted a retrospective observational analysis of electronic medical records from 8463 adults who received multidisciplinary care at Mexico’s primary care specialized units (UNEMES-EC) between 2015 and 2019 and who were referred for inadequate metabolic control. Remission was defined per 2021 ADA criteria as HbA1c <6.5% sustained for ≥3 months without glucose-lowering medications. After estimating the prevalence of T2D remission, logistic regression models were used to evaluate its sociodemographic and clinical predictors, with particular attention to weight change and baseline adiposity interactions. Results: RT2D prevalence was 0.87% (95% CI: 0.68–1.10) over a median 393-day follow-up. Weight loss ≥10% (adjusted OR 2.75; 95% CI: 1.21-6.27) and systolic blood pressure (tertile 3 vs tertile 1: OR 2.49; 95% CI: 1.17–5.26) were positively associated with RT2D, while elevated baseline HbA1c (tertile 3 vs. tertile 1: OR 0.09; 95% CI: 0.02–0.33), triglyceride levels (tertile 3 vs. tertile 1: OR 0.49; 95% CI: 0.24–0.98) and intensive pharmacotherapy were inversely associated with RT2D. No associations with HDL and total cholesterol were found. Age, sex, educational attainment, and income demonstrated no independent associations with remission. Among lifestyle-treated patients achieving ≥5% weight loss, remission prevalence reached approximately 11%. No significant interaction between baseline BMI and weight change was detected (p = 0.60). Conclusions: This first large-scale Mexican study establishes RT2D as an achievable endpoint in patients with poor baseline metabolic control. The findings suggest that remission could be achieved with equity-focused, weight-centered interventions even in resource-constrained health systems and populations.