685-P: Possibility of Oral Glucose Tolerance Test Clearance in Patients with Type 2 Diabetes Who Underwent Complete Diabetes Remission

Background and Aim­: Type 2 diabetes (T2D) remission through calorie and carbohydrate restriction has been reported. We conducted a pilot trial to observe whether oral Glucose tolerance test (OGTT) clearance is possible in T2D patients who underwent remission through a lifestyle modification program.

Methods: A total of 3689 patients who had previously undergone remission through our lifestyle modification program at Freedom from Diabetes Clinic, India, were asked to enroll for the OGTT; 1121 accepted the invitation and enrolled (June 2022). Remission was defined as HbA1c<48mmol/mol for a minimum of three months without glucose-lowering medication. Of 1121, 400 participants completed a 3-month training (where foods with increasing glycemic load were introduced every week while monitoring the blood sugar levels (BSL)). Subsequently, they appeared for OGTT (75g) from October-November 2022.

Results: Of the 400 participants, 207 (51.7%) cleared OGTT [Fasting BSL(FBSL)≤100, 2-hrs postprandial (PP2) <140], 175 (43.7%) cleared IGT-Impaired Glucose Tolerance (FBSL<126, PP2<200), while 18 (4.5%) did not clear. The median BMI at the time of appearing for OGTT was 22.8 kg/m². Those clearing OGTT had significantly higher weight loss during the program than those clearing IGT (10 kg vs 6.4 kg) and had a shorter duration of diabetes (5 years vs 6.9 years) (p<0.05). Medication status at the start of the intervention (OHA, Insulin, both, and no medication) did not affect the possibility of clearing OGTT (p>0.1).

Conclusion: Complete remission of type 2 diabetes to the point of achieving a nondiabetes glycemic profile irrespective of initial medication status is possible through lifestyle intervention if weight loss is achieved and maintained. The long-term sustainability of lifestyle interventions in achieving remission needs to be explored through a larger cohort study with a control group.