Early weight loss, diabetes remission and long-term trajectory after diagnosis of type 2 diabetes: a retrospective study – published 22/03/2025

Mario Luca Morieri, Mauro Rigato, Vera Frison, Michele D’Ambrosio, Giovanni Sartore, Angelo Avogaro & Gian Paolo Fadini

Weight loss in individuals with type 2 diabetes helps glycaemic management and can lead to remission, but for how long? In this issue, Morieri et al (https://doi.org/10.1007/s00125-025-06402-w) present findings from a large multicentre study that followed individuals with type 2 diabetes who lost >10% of their body weight. The authors report that although the participants maintained a lower weight over the observation period of up to 20 years, their HbA1c levels gradually rose. These findings challenge the assumption that long-term glycaemic efficacy is guaranteed if weight loss is sustained. For the diabetes community, this study highlights the need for continued metabolic support even after successful weight reduction, pointing to factors beyond body weight that contribute to glycaemic deterioration over time. The authors conclude that the obesocentric view that diabetes is caused by excess weight must be challenged, bearing in mind that beta cell dysfunction is a fundamental prerequisite for disease development.

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