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Residual beta-cell function and spontaneous clinical remission in type 1 diabetes mellitus: the role of puberty.

Abstract
To investigate the role of puberty on spontaneous clinical remission and on secretion of residual C-peptide during the first year of type 1 diabetes mellitus, we studied 77 pre-pubertal, 39 pubertal and 41 post-pubertal type 1 diabetic patients. Spontaneous partial clinical remission (HbA1c within the normal range and insulin dose less than 0.3 U x kg(-1) body weight x day(-1) lasting for at least 10 days) decreased with duration of diabetes: months 3 vs 6 vs 12, respectively 13 vs 7 vs 4% (P<0.025). Remission was higher in post-pubertal than pubertal and prepubertal patients: month 6 respectively 20 vs 5 vs 1% (P<0.001). Secretion of C-peptide was significantly lower in pre-pubertal than the other two groups of patients. Basal and stimulated C-peptide secretion were higher in patients in clinical remission than in those who were not: basal value 0.4 (0.26-0.53) vs 0.28 (0.14-0.4) nmol/l (P<0.05); stimulated value 0.63 (0.5-0.95) vs 0.56 (0.31-0.74) nmol/l (P<0.05). Spontaneous remission is less frequent in children and adolescent patients than in adult post-pubertal patients, but different mechanisms may be involved. Low residual insulin secretion seems implicated in children meanwhile low insulin sensitivity could be more important in pubertal patients.
AuthorsR Bonfanti, E Bognetti, F Meschi, A Brunelli, M C Riva, M R Pastore, G Calori, G Chiumello
JournalActa diabetologica (Acta Diabetol) Vol. 35 Issue 2 Pg. 91-5 (Jul 1998) ISSN: 0940-5429 [Print] Germany
PMID9747961 (Publication Type: Journal Article)
Chemical References
  • Insulin
Topics
  • Adolescent
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 (drug therapy, metabolism, physiopathology)
  • Female
  • Humans
  • Insulin (administration & dosage, metabolism, therapeutic use)
  • Insulin Secretion
  • Islets of Langerhans (metabolism)
  • Male
  • Puberty (physiology)
  • Remission, Spontaneous

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