Factors associated with the partial remission phase in diabetes mellitus: a systematic review and meta-analysis

This study aimed to identify and evaluate the factors associated with the partial remission phase in patients with diabetes mellitus (DM). Observational studies published up to November 2025 were searched in CNKI, Wanfang, VIP, PubMed, Web of Science, Cochrane Library, and EMBASE databases. Two researchers independently performed literature screening, quality assessment, and data extraction. Study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) checklist and the Newcastle–Ottawa Scale (NOS). A random-effects model was used to pool heterogeneous results. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). A total of 28 observational studies involving 18,537 participants were included. Seventeen relevant factors were identified in the analysis. Higher glycated hemoglobin (HbA1c) levels were associated with a lower likelihood of entering the partial remission phase (pooled OR = 0.90, 95% CI 0.86–0.94, P < 0.001). Higher daily insulin requirements were also associated with reduced odds of partial remission (pooled OR = 0.71, 95% CI 0.56–0.90, P < 0.01). The presence of diabetic ketoacidosis (DKA) was associated with a lower likelihood of partial remission (pooled OR = 0.56, 95% CI 0.45–0.70, P < 0.001). In addition, older age at onset was associated with a slightly higher likelihood of entering the partial remission phase (pooled OR = 1.05, 95% CI 1.00–1.10, P < 0.05). The occurrence of partial remission phase of DM is related to multiple factors. Lower HbA1c levels, lower daily insulin requirements, and the absence of DKA were associated with a greater likelihood of entering the partial remission phase, while older age at onset may increase the likelihood of entering this phase. Optimal early glycemic control and active prevention of DKA may help increase the probability of patients with diabetes entering the partial remission phase.