Time to first remission and associated factors in type 2 diabetes mellitus: a retrospective cohort study in Ethiopia

Background The prevalence of type 2 diabetes mellitus (T2DM) is rising in Ethiopia. Treatment for remission reduces further complications and the timing of these outcomes is influenced by various factors. However, there was a paucity of evidence in the Ethiopian context about these issues. This study examined the time to first remission and associated factors in T2DM patients treated at two referral hospitals in Eastern Ethiopia. Methods A census-based retrospective cohort study was employed and analyzed secondary data from 1162 T2DM patients treated at two Hospitals between January 2017 and December 2021. Following descriptive analysis, Kaplan-Meier survival analysis was used to estimate the time to first remission, and Cox proportional hazards models were employed to identify factors associated with remission time. Results Within a five-year follow-up period, 701 (60.33%) patients achieved first remission. Among those who achieved remission, 92.58% reached this milestone within the first 24 months of follow-up. Male gender, older age, family history of diabetes, comorbidities, increased cholesterol levels, and therapy at Dil-Chora Referral Hospital were all related to a longer duration of initial remission. Male gender was related to an 11.81% longer remission duration than females (HR = 0.8819, p = 0.006). Similarly, individuals with comorbidities had an 11.25% longer remission duration (HR = 0.8875, p < 0.001). Conclusion A significant majority of T2DM remissions occur within a critical two-year window following treatment initiation, identifying this period as the golden opportunity’ for intensive clinical intervention. These findings underscore the necessity of implementing early, aggressive glycemic management and multidisciplinary care models to maximize remission potential. Future research should prioritize investigating the biological drivers of early treatment success and the long-term durability of remission in the Ethiopian context. Clinical trial number Not applicable.