In many people’s perception, once diagnosed with type 2 diabetes mellitus (T2DM), it means lifelong medication, strict glycemic control, and constant risk of complications. However, in recent years, the concept of “diabetes remission” has quietly changed clinical practice—not a cure, but long-term maintenance of blood glucose at non-diabetic levels through scientific intervention, without medication, and with significantly improved quality of life.
Recently, a landmark real-world study covering 1,000 patients with type 2 diabetes was released, focusing on an innovative “2+N Systematic Therapy”. The results showed that more than one-third of patients achieved diabetes remission, and nearly 70% achieved significant improvements in metabolic indicators! This clinical practice achievement developed in China brings new hope to hundreds of millions of people with diabetes.
T2DM represents a major global public health challenge. Although traditional pharmacotherapy can control blood glucose, it is difficult to reverse insulin resistance and beta-cell dysfunction, often requiring lifelong medication. Recent studies (such as the DiRECT trial) have shown that reducing liver and pancreatic fat through weight loss and lifestyle intervention in the early course of the disease can achieve T2DM remission. However, its promotion is limited by low compliance, resource intensity, and other issues.
To address this, the research team has implemented the “2+N Systematic Therapy” since 2015. The “2” refers to an integrated traditional Chinese and Western medicine medication strategy, while “N” covers multidimensional lifestyle interventions including personalized nutrition, exercise, and psychological support. Preliminary practice has demonstrated significant effects in glycemic control, weight loss, and metabolic improvement.
This real-world study was conducted at the Diabetes and Obesity Reversal Center of a Chinese hospital from May 2015 to January 2022, enrolling a total of 1,000 adult T2DM patients who were overweight or obese (body mass index, BMI ≥ 24 kg/m²), aiming to evaluate the clinical efficacy of the “2+N Systematic Therapy”.
Inclusion criteria:Met T2DM diagnostic criteria of ADA/Chinese guidelines (glycated hemoglobin, HbA1c ≥ 6.5%, etc.), disease duration ≤ 5 years, fasting C-peptide ≥ 1.0 ng/mL, and no severe complications.
Exclusion criteria:Secondary diabetes, autoimmune diabetes, and end-stage organ damage.The overall screening criteria were consistent with the “ABCD” diabetes remission assessment framework.
The “2” component:Integrated traditional Chinese and Western medicine medication management (e.g., short-term intensive insulin therapy followed by transition to GLP-1 RA/metformin, with gradual tapering and discontinuation).
The “N” component:
Personalized medical nutrition (1,000–1,500 kcal/day, low-carbohydrate, high-protein)
Structured exercise (≥ 150 minutes/week of aerobic plus resistance training)
Psychological support and diabetes educationApproximately 80% of patients also received standardized acupuncture (at acupoints such as ST36, CV6, etc.).A hybrid “online + offline” model combined with an AI health app was used for diet, exercise, blood glucose tracking, and remote guidance.
The intervention period was 3–6 months, with metabolic indicators assessed at baseline, 3 months, and 6 months.
Primary endpoint: Clinical diabetes remission, defined as discontinuation of all hypoglycemic agents for ≥ 3 months with HbA1c < 6.5%.
Secondary endpoints: Changes in body weight, HbA1c, blood lipids, HOMA-IR, and ectopic fat (hepatic/pancreatic fat content was quantitatively measured by MRI in 26 patients).Data analysis was performed using R (v4.2.0) and GraphPad Prism 8, with P < 0.05 as the threshold for statistical significance.Although this study used a non-randomized observational design, the standardized intervention protocol and strict follow-up mechanism strongly validated the feasibility, effectiveness, and scalability of the “2+N Systematic Therapy” in achieving T2DM remission and metabolic remodeling in real clinical settings.