The application of the 2021 international consensus statement, defining type 2 diabetes remission as A1c less than 6.5% at least 3 months after stopping glucose-lowering therapy, remains unexplored in retrospective claims-based studies. We used de-identified administrative claims enriched with laboratory values from commercial and Medicare Advantage plans to identify the

  • (1) proportion of individuals with insufficient data to be assessed for remission

  • (2) prevalence of diabetes remission and

  • (3) sensitivity of remission definitions to changes in claims-based logic.

We designed three alternative definitions adapted to claims by varying the glycemic, temporal, and pharmacologic components. Among 524,076 adults with a type 2 diabetes claim and an available A1c value of at least 6.5%, 185,285 (35.4%) had insufficient additional laboratory values and/or enrollment data to assess for remission. Of the 338,791 who were assessable for remission, 10,694 (3.2%) met the consensus statement definition. The proportion meeting the three alternative definitions ranged from 0.8% to 2.3%, demonstrating the feasibility of a laboratory-value enriched claims-based assessment of remission. Establishing stable claims-based markers of remission can enable population assessments and evaluate the association between remission and clinical outcomes.


N.Sheils: Employee; UnitedHealth Group, Stock/Shareholder; UnitedHealth Group. M.Jarvis: Employee; UnitedHealth Group, Stock/Shareholder; UnitedHealth Group. L.Bangerter: Employee; UnitedHealth Group. D.Asch: Other Relationship; UnitedHealth Group, VAL Health. C.Clark: Employee; UnitedHealth Group, Stock/Shareholder; UnitedHealth Group.

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