Features of the debut of diabetes mellitus type 1 development of remission
https://doi.org/10.14341/probl200046214-16
Abstract
After clinical manifestation in most patients with insulin-dependent diabetes mellitus (IDDM), a transient decrease in insulin demand is associated with an improvement in the function of the remaining p-cells within 1 to 6 months. This most favorable period during IDDM has been called the “Honeymoon”, or remission period. Complete clinical remission of the disease, accompanied by the abolition of insulin therapy, occurs in 2-12% of patients. Partial remission (daily requirement for exogenous insulin of less than 0.4 U / kg body weight) has been described in 18–62% of young patients with IDDM [4, 17, 32]. The best (with a minimum need for insulin) and longer remission is observed in older patients at the time of the onset of the disease, in the absence of severe initial manifestations of the disease [17, 38], at low titers of autoantibodies to islet cell cytoplasm (1CA) or glutamate decarboxylase (GAD ) or their absence | 31,35,41]. In most studies, the point of view is expressed that a greater preservation of p-cell function is associated with achieving optimal metabolic control (Hb A1c) and maintaining the response of a cells to hypoglycemia by secretion of glucagon [15].
About the Authors
O. M. SmirnovaEndocrinology Research Centre
Russian Federation
V. A. Gorelysheva
Endocrinology Research Centre
Russian Federation
I. I. Dedov
Endocrinology Research Centre
Russian Federation
References
1. Горелышева В. А., Смирнова О. М., Дедов И. И. // Мед, фармацевт. вести. — 1996. — № 4—5. — С. 47—54.
2. Кураева Т. Л. // Пробл. эндокринол. — 1991. — Т. 37, № 1. С. 63-67.
3. Смирнова О. М. Клинические, иммуногенетические, гормонально-метаболические аспекты впервые выявленного инсулинзависимого сахарного диабета: Дис. ... д-ра мед. наук. — М., 1995.
4. Agner Т, Damm Р., Binder С. // Diabetes Саге. — 1987. — Vol. 10. Р. 164-169.
5. Andreani D., Mario U. D., Pozzilli P. // Diabet. Metab. Rev. — Vol. 7. P. 61-77.
6. Baker L., Kaye R., Root А. Ж // J. Pediat. — 1967. — Vol. 71. — P. 825-831.
7. Boitard С. H. // Diabetologia. — 1992. — Vol. 35. — P. 1101-1112.
8. Bonora E., Coscelli C., Butturini U. // Acta diabetol. lat. — 1984. Vol. 21. P. 375-383.
9. Canadian-European Randomized Clinical Trial Group // Diabetes. 1988. Vol. 37. P. 1574-1582.
10. Cook D., Taborsky G. // Diabetes Mellitus. Theory and Practice / Eds H. Rifkin, D. Porte. — New York, 1990. — P. 92—95.
11. Drell D. W., Notkins A. L. // Diabetologia. — 1987. — Vol. 30. — P. 132-143.
12. Eisenbarth G. S. // New Engl. J. Med. — 1989. — Vol. 314. — P. 1360-1368.
13. Elliott R. B., Bibby N. J., Reddy S. // International Workshop on Immunology of Diabetes, 19-th: Proceedings / Eds E. Shafir, P. Vardy. — Jerusalem, 1990. — P. 34.
14. Feutren G., Papoz L., Assan R. et al. // Lancet. — 1986. — Vol. 2. P. 119-123.
15. Fukuda M., Tanaka Y., Tanaka A. et al. // Diabetes. — 1988. — Vol. 37. P. 81-87.
16. Inone Y., Tanigawa K., Tamura K. et al. // Diabetologia. — Vol. 35, Slippl. 1. P. Al 15.
17. Knip M., Sakkinen A., Huttunen N. et al. // Acta paediat. scand. 1982. Vol. 71. P. 901-908.
18. Knip M., llonen J., Mustonen A., Akerblom H. K. // Diabetologia. 1986. Vol. 29. P. 347-351.
19. Kolb H. // Diabet. Metab. Rev. 1987. Vol. 3. P. 751-778.
20. Kolb H., Dannehl K., Gruneclee D. et al. // Diabetologia. — Vol. 31. P. 189-194.
21. Kolb H.. Burkard V., Appels M. // J. Autoimmun. — 1990. — Vol. 3. P. 1-4.
22. Kolb H., Kolb-Bachofen V. // Diabetologia. — 1992. — Vol. 35. P. 796-797.
23. Lampeter F. // Diabete et Metab. — 1993. — Vol. 19. — P. 105-109.
24. Lazarow A. // Anat. Rec. — 1947. — Vol. 97. — P. 353—358.
25. Madsbad S., Bottazzo G. E. Cudworth A. G. et al. // Diabetologia. 1980. Vol. 18. P. 45-47.
26. Madsbad S. // Ibid. 1983. Vol. 24. P. 141-147.
27. Martin S., Schernthaner G., Nerup J. et al. // Ibid. — 1991. — Vol. 34. P. 429-434.
28. Nakajama H., Fujino-Kurihara H.. Hanafusa T. et al. // Biomed. Res. — 1985. — Vol. 6. — P. 185—189.
29. Nomicos I. N., Prowse S. J., Carotenuto P. // Diabetes. — 1986. Vol. 35. P. 1302-1304.
30. Okamoto H. // Bioessays. — 1985. — Vol. 2. — P. 15—21.
31. Petersen J. S., Dvrberg T., Karlsen A. E. et al. // Diabetes. — 1994. Vol. 43.' P. 1291-1296.
32. Pinkney J. H.. Bingney P. J., Sawtel P. A. et al. // Diabetologia. 1994. — Vol. 37. P. 70-74.
33. Pipeleers D.. Ling Z. // Diabet. Metab. Rev. — 1992. — Vol. 8. P. 209-227.
34. Pozzilli P., Singapore A., Andreani D. // Diabetologia. — 1992. — Vol. 35. P. 1093-1095.
35. Schiffrin A., Suissa S., Poussier P. et al. // Diabetes. — 1988. — Vol. 37. P. 920-925.
36. Shah S. C., Malone J. /., Simpson N. E. // New Engl. J. Med. — Vol. 320. P. 550-554.
37. Shehaden N.. Karnieli E., Bruchim I. et al. // International Immunology and Diabetes Workshop, 13-th. — Mont-villar genne, France, 1994.
38. Sochett E. B., Dane man D., Clarson C., Ehrlich R. M. // Diabetologia. 1987. Vol. 30. P. 453-459.
39. Sudre Y., Marechaud R.. Rossi F. et al. // Rev. Med. Int. — 1984. Vol. 5. P. 206-211.
40. Uchigata Y., Yamamoto H., Nagai H. et al. // Diabetes. — Vol. 32. P. 316-318.
41. Wallesteen M., Dahlquist G., Persson B. et al. // Diabetologia. — 1988. Vol. 31. P. 664-669.
42. Yonemura Y., Takashima T, Miwa K. et al. // Diabetes. — Vol. 33. P. 401-404.
Review
For citations:
Smirnova O.M., Gorelysheva V.A., Dedov I.I. Features of the debut of diabetes mellitus type 1 development of remission. Problems of Endocrinology. 2000;46(2):14-16. (In Russ.) https://doi.org/10.14341/probl200046214-16
Views:
8124
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
.jpg){kind=logo}
