Abstract:
A \"honeymoon\" phase is a transient period of type 1 diabetes (T1D) remission, characterized by a significant reduction in insulin requirements and good glycemic control due to a temporary restoration of pancreatic β-cell function. This phenomenon occurs in about 60% of adults with this disease, is usually partial, and lasts for up to 1 year. We present a case of a 6-year complete remission of T1D in a 33-year-old man, the longest remission ever described in the literature to our knowledge. He was referred for presenting a 6-month history of polydipsia, polyuria, and weight loss of 5 kg. Laboratory studies confirmed the diagnosis of T1D (fasting blood glucose of 270 mg/dL; HbA1c of 10.6%, and positive antiglutamic acid decarboxylase), and the patient started intensive insulin therapy. After 3 months, a complete remission of the disease was assumed, he suspended insulin administration and since then, he has been under treatment with sitagliptin 100 mg daily, a low-carbohydrate diet, and regular aerobic physical activity. This work aims to highlight the potential role of these factors in delaying disease progression and preserving pancreatic β-cells when introduced at the time of presentation. More robust, prospective, and randomized studies will be needed to confirm its protective effect on the natural course of the disease and support its indication in adults with newly diagnosed T1D.
摘要:
“蜜月期”是1型糖尿病(T1D)缓解的短暂时期,其特征是由于胰腺β细胞功能的暂时恢复,胰岛素需求显着降低和良好的血糖控制。这种现象发生在大约60%的成年人患有这种疾病,通常是局部的,并持续长达1年。我们介绍了一个33岁男性T1D6年完全缓解的病例,据我们所知,文献中描述的最长的缓解期。他因为有6个月的多饮病史而被推荐,多尿,和5公斤的重量损失。实验室研究证实诊断为T1D(空腹血糖为270mg/dL;HbA1c为10.6%,和抗谷氨酸脱羧酶阳性),患者开始胰岛素强化治疗。三个月后,假设疾病完全缓解,他暂停了胰岛素管理,从那以后,他每天服用西格列汀100毫克,低碳水化合物饮食,和有规律的有氧运动。这项工作旨在强调这些因素在延迟疾病进展和保留胰腺β细胞时的潜在作用。更强大,prospective,和随机研究将需要证实其对疾病的自然病程的保护作用,并支持其在新诊断的T1D成人中的适应症。