Diabetes remission in drug-naive patients with type 2 diabetes after dorzagliatin treatment: A prospective cohort study

Aim: To investigate the post-treatment effect of dorzagliatin in drug-naive patients with type 2 diabetes (T2D) regarding the achievement of stable glycaemic control and drug-free diabetes remission. Materials and Methods: Patients who completed dorzagliatin treatment in the SEED trial and achieved stable glycaemic control were enrolled in this 52-week study without any antidiabetic medication. The primary endpoint was the diabetes remission probability at week 52 using the Kaplan-Meier method. The potential factors that contribute to stable glycaemic control and diabetes remission based on the characteristics of patients before and after treatment with dorzagliatin were analysed. A post hoc sensitivity analysis of diabetes remission probability using the American Diabetes Association (ADA) definition was conducted. Results: The Kaplan-Meier remission probability was 65.2% (95% CI: 52.0%, 75.6%) at week 52. Based on the ADA definition, the remission probability was 52.0% (95% CI: 31.2%, 69.2%) at week 12. The significant improvements in the insulin secretion index Delta C30/Delta G30 (41.46 +/- 77.68, P = .0238), disposition index (1.22 +/- 1.65, P = .0030), and steady-state variables of HOMA2-beta (11.49 +/- 14.58, P < .0001) and HOMA2-IR (-0.16 +/- 0.36, P = .0130) during the SEED trial were important factors in achieving drug-free remission. A significant improvement in time in range (TIR), a measure of glucose homeostasis, in the SEED trial from 60% to more than 80% (estimated treatment difference, 23.8%; 95% CI: 7.3%, 40.2%; P = .0084) was observed. Conclusions: In drug-naive patients with T2D, dorzagliatin treatment leads to stable glycaemic control and drug-free diabetes remission. Improvements in beta-cell function and TIR in these patients are important contributors to diabetes remission.