PDF(Pubmed)
Abstract：
The knowledge of the pathogenesis of type 1 diabetes mellitus (T1DM) continues to rapidly evolve. The natural course of the disease can be described in four clinical stages based on the autoimmune markers and glycemic status. Not all individuals of T1DM progress in that specific sequence. We hereby present a case of T1DM with a classical third phase (honeymoon phase) and discuss the intricacies of this interesting phase along with a possible future promise of \"cure\" with the use of immunotherapies. We now know that the course of T1DM may not be in only one direction towards further progression; rather the disease may have a waxing and waning course with even reversal of type 1 diabetes concept being discussed. The third phase popularly called the \"honeymoon phase\", is of special interest as this phase is complex in its pathogenesis. The honeymoon phase of T1DM seems to provide the best window of opportunity for using targeted therapies using various immunomodulatory agents leading to the possibility of achieving the elusive \"diabetes reversal\" in T1DM. Identifying this phase is therefore the key, with a lot of varying criteria having been proposed.
摘要：
对1型糖尿病（T1DM）发病机理的认识继续迅速发展。根据自身免疫标志物和血糖状态，可以在四个临床阶段描述疾病的自然过程。并非所有T1DM个体都在该特定序列中进展。我们在此介绍一个典型的第三阶段（蜜月期）的T1DM病例，并讨论这一有趣阶段的复杂性以及使用免疫疗法可能的“治愈”的未来承诺。我们现在知道，T1DM的病程可能不仅仅是朝着进一步发展的一个方向发展；相反，该疾病可能有一个逐渐减弱的过程，甚至正在讨论1型糖尿病的概念。第三阶段通常被称为“蜜月阶段”，是特别感兴趣的，因为这个阶段是复杂的发病机制。T1DM的蜜月期似乎为使用各种免疫调节剂的靶向治疗提供了最佳的机会窗口，从而有可能在T1DM中实现难以捉摸的“糖尿病逆转”。因此，识别这个阶段是关键，提出了许多不同的标准。
