Vol 2, No 5 (2013)
Review article
Submitted: 2013-10-25
Accepted: 2013-10-25
Published online: 2013-10-25
Clinical remission of type 1 diabetes
Paweł Niedźwiecki, Dorota Zozulińska-Ziółkiewicz
Diabetologia Kliniczna 2013;2(5):185-190.
Vol 2, No 5 (2013)
Review
Submitted: 2013-10-25
Accepted: 2013-10-25
Published online: 2013-10-25
Abstract
In natural history of type 1 diabetes gradual reduction of β-cell mass proceed during several years. Clinically symptoms of diabetes develop when β-cell mass reach state in which insulin secretion will be insuffi cient tokeep glycaemia in normal range. Diabetes occurs when 80–90% of islet cells will be destroyed. Pathogenesis of autoimmune destruction of β-cell is not fully understood. It includes interaction between genetic, environmental factors and appearing autoantibodies. Soon after diagnosis of type 1 diabetes and introducing insulin therapy reduction of exogenous insulin requirement is observed. This phenomenon is called clinical remission. Because of the ambiguous diagnostic criteria, identifying and comparing the frequency of occurrence of remission in type 1 diabetes is diffi cult. Despite of difference in remission criteria, they all underline residual insulin secretion. Most of remission criteria take into account following parameters: glycated hemoglobin value, daily exogenous insulin requirement and C-peptide serum level. Occurrence of remission is extremely desirable in type 1 diabetes. It influences positively on metabolic control of diabetes, reduces the risk of hypoglycaemia, improves quality of life and probably infl uence on development of chronic complications. This paper summarizes the current state of knowledge in the fi eld of clinical remission of type 1 diabetes.
Abstract
In natural history of type 1 diabetes gradual reduction of β-cell mass proceed during several years. Clinically symptoms of diabetes develop when β-cell mass reach state in which insulin secretion will be insuffi cient tokeep glycaemia in normal range. Diabetes occurs when 80–90% of islet cells will be destroyed. Pathogenesis of autoimmune destruction of β-cell is not fully understood. It includes interaction between genetic, environmental factors and appearing autoantibodies. Soon after diagnosis of type 1 diabetes and introducing insulin therapy reduction of exogenous insulin requirement is observed. This phenomenon is called clinical remission. Because of the ambiguous diagnostic criteria, identifying and comparing the frequency of occurrence of remission in type 1 diabetes is diffi cult. Despite of difference in remission criteria, they all underline residual insulin secretion. Most of remission criteria take into account following parameters: glycated hemoglobin value, daily exogenous insulin requirement and C-peptide serum level. Occurrence of remission is extremely desirable in type 1 diabetes. It influences positively on metabolic control of diabetes, reduces the risk of hypoglycaemia, improves quality of life and probably infl uence on development of chronic complications. This paper summarizes the current state of knowledge in the fi eld of clinical remission of type 1 diabetes.
Keywords
type 1 diabetes, clinical remission, intensive functional insulin therapy, immunointervention, physical activity
Title
Clinical remission of type 1 diabetes
Journal
Clinical Diabetology
Issue
Vol 2, No 5 (2013)
Article type
Review article
Pages
185-190
Published online
2013-10-25
Page views
1868
Article views/downloads
11435
Bibliographic record
Diabetologia Kliniczna 2013;2(5):185-190.
Keywords
type 1 diabetes
clinical remission
intensive functional insulin therapy
immunointervention
physical activity
Authors
Paweł Niedźwiecki
Dorota Zozulińska-Ziółkiewicz