家庭医学と医療科学の研究
オープンアクセス

概要

Remission in Type 1 Diabetes - What's New?

Chwalba Artur and Ewa Otto-Buczkowska

Type 1 diabetes is an autoimmune disease, in which there is a destruction of pancreatic islets βcells. In the natural course of the disease we deal with a gradual progress during the few years of reduction of cell mass. The symptoms of diabetes appear when the mass of insulin-secreting β cells will be reduced by about 80-90%. In this state, the amount of insulin is insufficient to ensure normoglycemia. Many patients shortly after diagnosis of diabetes type 1 and initiation of insulin therapy come to partial cell β renewal and consequently to reduce the need for exogenous insulin. This phenomenon is called the remission of the disease. This period is also called honeymoon. The glucose concentration decreases so the insulin dose should be also reduced, however complete cessation of insulin is not recommended. Accuracy to determine and compare the prevalence of type 1 diabetes remission is difficult because of ambiguous criteria for its diagnosis: most remission criteria take into account the following parameters:glycated hemoglobin (HbA1c), daily need for exogenous insulin, and the concentration C-peptide in the blood. In all definitions of remission, although different criteria are used, residual insulin secretion is underlined, as well as demonstrated measurement of C-peptide and low demand on exogenous insulin.