Factors Influencing Frequency and Duration of Remission in Children and Adolescents Newly Diagnosed with Type 1 Diabetes

Background This study aimed to determine the frequency and duration of remission in children and adolescents newly diagnosed with type 1 diabetes and to investigate factors associated with these parameters. Material/Method Fifty patients newly diagnosed with T1DM were followed for 1 year. Daily insulin requirement of less than 0.5 U/kg/day dose when the HbA1c value is less than 8% was regarded as partial remission. Patients were grouped according to their remission duration. Clinical and laboratory characteristics of the remission groups and non-remission groups were compared to find factors influencing remission and to investigate their contribution to the duration of remission. Results Remission was observed in 24 (48%) out of 50 patients included in the study. Remission frequency was found to be associated with age, sex, and puberty. Longer duration of remission was more frequent in the younger age group, in pre-pubertal stage, and in male patients. Daily insulin dose and basal insulin requirement of those who went into remission was found to be significantly lower than in the other patients at discharge. Conclusions Decreased daily total and basal insulin requirement at discharge are valuable in predicting remission. The remission process in type 1 diabetes still has many characteristics that need to be clarified. Therefore, more extensive studies are needed.

[1]  S. Srikanta,et al.  Type 1 diabetes pathogenesis – Prevention??? , 2015, Indian journal of endocrinology and metabolism.

[2]  R. Hoffman,et al.  Young children (<5 yr) and adolescents (>12 yr) with type 1 diabetes mellitus have low rate of partial remission: diabetic ketoacidosis is an important risk factor , 2008, Pediatric diabetes.

[3]  M. Abdul-Rasoul,et al.  ‘The honeymoon phase’ in children with type 1 diabetes mellitus: frequency, duration, and influential factors , 2006, Pediatric diabetes.

[4]  L. Nyström,et al.  Normal weight promotes remission and low number of islet antibodies prolong the duration of remission in Type 1 diabetes , 2004, Diabetic medicine : a journal of the British Diabetic Association.

[5]  F. Lombardo,et al.  Two-year prospective evaluation of the factors affecting honeymoon frequency and duration in children with insulin dependent diabetes mellitus: the key-role of age at diagnosis. , 2002, Diabetes, nutrition & metabolism.

[6]  E. Bonifacio,et al.  Parameters associated with residual insulin secretion during the first year of disease in children and adolescents with Type 1 diabetes mellitus , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[7]  E. Bognetti,et al.  Residual beta-cell function and spontaneous clinical remission in type 1 diabetes mellitus: the role of puberty , 1998, Acta Diabetologica.

[8]  Å. Lernmark,et al.  Age governs gender‐dependent islet cell autoreactivity and predicts the clinical course in childhood IDDM , 1997, Acta paediatrica.

[9]  M. Knip,et al.  Effect of genetic risk load defined by HLA‐DQB1 polymorphism on clinical characteristics of ID DM in children , 1995, European journal of clinical investigation.

[10]  A. Ziegler,et al.  Natural Course of Remission in IDDM During 1st yr After Diagnosis , 1992, Diabetes Care.

[11]  T. Agner,et al.  Remission in IDDM: Prospective Study of Basal C-Peptide and Insulin Dose in 268 Consecutive Patients , 1987, Diabetes Care.

[12]  M. Knip,et al.  POSTINITIAL REMISSION IN DIABETIC CHILDREN– AN ANALYSIS OF 178 CASES , 1982, Acta paediatrica Scandinavica.

[13]  C. Dayan,et al.  The importance of residual endogenous beta-cell preservation in type 1 diabetes , 2009 .

[14]  L. Gortner,et al.  Shorter remission period in young versus older children with diabetes mellitus type 1. , 2007, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[15]  M. Knip,et al.  Ketoacidosis at the diagnosis of type 1 (insulin dependent) diabetes mellitus is related to poor residual cell function , 2006 .

[16]  E. Böber,et al.  Partial Remission Phase and Metabolic Control in Type 1 Diabetes Mellitus in Children and Adolescents , 2001, Journal of pediatric endocrinology & metabolism : JPEM.

[17]  F. Chiarelli,et al.  Factors Influencing Remission Phase in Children with Type 1 Diabetes Mellitus , 2001, Journal of pediatric endocrinology & metabolism : JPEM.

[18]  Å. Lernmark,et al.  Prognostic factors for the course of beta cell function in autoimmune diabetes. , 2000, The Journal of clinical endocrinology and metabolism.

[19]  M. de Luise,et al.  Diabetes mellitus. , 1993, The Medical journal of Australia.