Abstract:
Herein, we describe an unusually prolonged duration (31 months) of the clinical remission phase in a 22-year-old Italian man with new-onset type 1 diabetes. Shortly after the disease diagnosis, the patient was treated with calcifediol (also known as 25-hydroxyvitamin D3 or calcidiol), coupled with low-dose basal insulin, to correct hypovitaminosis D and to exploit the anti-inflammatory and immunomodulatory properties of vitamin D. During the follow-up period, the patient retained a substantial residual β-cell function and remained within the clinical remission phase, as evidenced by an insulin dose-adjusted glycated hemoglobin value <9. At 24 months, we detected a peculiar immunoregulatory profile of peripheral blood cells, which may explain the prolonged duration of the clinical remission sustained by calcifediol as add-on treatment to insulin.
We describe the case of a 22-year-old Italian man who was treated with a form of vitamin D called calcifediol shortly after the diagnosis of type 1 diabetes, which is an autoimmune condition leading to insulin deficiency and to the lifelong need for insulin therapy. Calcifediol was administered, coupled with low-dose insulin, to correct vitamin D insufficiency and to exploit the anti-inflammatory properties of vitamin D. During the follow-up period (31 months), the patient unexpectedly remained on once-daily insulin injection therapy and maintained near-normal blood glucose levels. These findings suggest that calcifediol administration may represent a valid add-on treatment to insulin, with the aim of reducing daily insulin requirements and improving glucose control in patients with recent-onset type 1 diabetes.
摘要:
在这里,我们描述了一名22岁意大利新发1型糖尿病患者的临床缓解期持续时间异常延长(31个月).疾病诊断后不久,患者接受骨化二醇(也称为25-羟基维生素D3或骨化二醇)治疗,再加上低剂量的基础胰岛素,纠正维生素D缺乏症并利用维生素D的抗炎和免疫调节特性。在随访期间,患者保留了大量残留的β细胞功能,并保持在临床缓解期,胰岛素剂量调整的糖化血红蛋白值<9证明。24个月时,我们检测到外周血细胞特有的免疫调节特征,这可以解释骨化二醇作为胰岛素的附加治疗持续的临床缓解持续时间延长。
我们描述了一名22岁的意大利男子在诊断为1型糖尿病后不久接受了一种称为骨化二醇的维生素D治疗的情况。这是一种导致胰岛素缺乏和终身需要胰岛素治疗的自身免疫性疾病。服用了骨化二醇,再加上低剂量的胰岛素,纠正维生素D不足并利用维生素D的抗炎特性。在随访期间(31个月),患者意外地继续接受每日一次的胰岛素注射治疗,并维持接近正常的血糖水平.这些发现表明,骨化二醇的给药可能是一种有效的胰岛素附加治疗,目的是降低近期发病的1型糖尿病患者的每日胰岛素需求和改善血糖控制。