he 2022 Guidelines Update introduced a transformative concept: Type 2 diabetes is not necessarily a permanent, progressive condition. These flashcards are designed to help pharmacists and healthcare professionals quickly recall the evidence-based criteria for remission, the specific interventions (lifestyle and surgical) that drive it, and the safety protocols required for deprescribing medications.
Key Topics Covered:
Defining Remission: Memorizing the diagnostic criteria: an A1C <6.0% (on two tests) after at least 3 months without any glucose-lowering pharmacotherapy.
Intervention Strategies: Identifying Low-Energy Diets (LED) (800–1000 kcal/day, often using meal replacements) and bariatric surgery as the most effective methods for achieving remission.
Deprescribing Protocols: Reviewing the safety steps for stopping insulin, sulfonylureas, and SGLT2 inhibitors at the start of an intervention to prevent hypoglycemia and euglycemic DKA.
Terminology: Understanding why the term “remission” is used instead of “reversal” or “cure”—signaling that the risk of relapse remains and ongoing monitoring is essential.
Predictors of Success: Recalling that a shorter duration of diabetes (<6 years), younger age, and significant weight loss are strong predictors of achieving remission.