Abstract Body

Background: The extent to which remission of type 2 diabetes is associated with reduced cardiovascular disease (CVD) outcomes in key subgroups is unknown. We aimed to quantify the association between type 2 diabetes remission and 5-year incidence of CVD outcomes, overall and in pre-defined subgroups.

Methods: A retrospective cohort analysis of 65,347 adults with type 2 diabetes from the Care and Health Information Analytics (CHIA) database. Multivariable Cox models assessed the association between remission within the first two years of follow-up and incidence of CVD outcomes including events, microvascular and macrovascular complications at 7-year follow-up. Effect modification by age, sex, diabetes duration, pre-existing CVD, baseline body mass index (BMI) and HbA_1c level were assessed.

Results: 29,705 (46.0%) people achieved remission during the first two years of follow-up. Overall, remission was associated with lower risk of CVD outcomes. Remission was associated with reduced risk of CVD events and microvascular complications for younger age groups (aHR ranging from 0.51(0.38-0.69) to 0.85(0.76-0.96)) but not in those aged 85+ years (aHR: 0.74 (0.52-1.05) and aHR: 0.77 (0.60-1.00), respectively). People with no comorbidities had lowest risk of CVD events (aHR: 0.67(0.57-0.77), microvascular complications (aHR: 0.64(0.58-0.70)), macrovascular complications (aHR: 0.74(0.64-0.84)) compared to those with 1-2 or more than 3 comorbidities (aHR: 0.79 (0.67-0.93), aHR: 0.81(0.72-0.90), aHR: 0.83(0.73-0.95), respectively). There were no significant interactions in the remaining subgroups.

Conclusions: Achieving remission of type 2 diabetes is associated with a lower risk of CVD outcomes, particularly for younger groups and those with few comorbidities. Targeted interventions that focus on promoting remission in these groups may reduce the impact of CVD and associated health costs.