Remission in Diabetes

Pirart, J; Lauvaux, J. P.

doi:10.1007/978-3-642-47669-3_17

Cited by 7 publications

(7 citation statements)

References 124 publications

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“…Pirart and Lauvaux (18) described a series of 280 European NIDDM subjects in remission. Their patients had presented with mild hyperglycemia of 16.7 mmol/1; 104 of 280 lost >10% of their body weight, and 50% relapsed within the first year of remission (18). Our population differs remarkably from theirs, and no comparison seems valid.…”

Section: Discussionmentioning

confidence: 91%

Long-Term Normoglycemic Remission in Black Newly Diagnosed NIDDM Subjects

1996

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We have defined and characterized the natural history of spontaneous near-normoglycemic remission off of antidiabetic medication in 79 black NIDDM subjects. They had initially presented with plasma glucose levels of 37.8 +/- 19.3 mmol/l. Baseline clinical metabolic and 8-year prospective data were obtained (51 men and 28 women, mean age 45 +/- 10 years, islet-cell or GAD antibody negative). After hospitalization and intensive outpatient treatment, near-normoglycemic remission (fasting plasma glucose 6.1 +/- 0.83 mmol/l and HbA1c 0.95 +/- 0.10 of upper limit of normal) occurred within 8 +/- 10 months of insulin or sulfonylurea therapy. This was unrelated to the resolution of stress or significant weight loss (1.9 +/- 4.97 kg). Metabolic studies performed during remission showed 17% normal, 33% impaired, and 50% diabetic glucose tolerance. Glucose disposal (1 mU x kg-1 x min-1) euglycemic insulin clamp with D-[3(-3)H]glucose) was higher in the normal glucose tolerance group compared with the impaired and diabetic groups (37.8 +/- 10.2 vs. 26.1 +/- 10.7 and 26.7 +/- 12.0 micromol x kg-1 x min-1; P < 0.05) despite similar BMIs in all three groups (28.8 +/- 3.7 kg/m2). Insulin secretion was below the normal range. Of 79 patients, 27 relapsed. A Kaplan-Meier survival analysis gives a median time of 40 months to relapse. Higher presenting plasma glucose and male sex predicted earlier relapse. Near-normoglycemic remission may occur in up to 30% of black new-onset NIDDM patients. It appears to be associated with intensive initial glycemic regulation and may be a method of decreasing the development of microvascular complications in NIDDM.

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Section: Discussionmentioning

confidence: 91%

Long-Term Normoglycemic Remission in Black Newly Diagnosed NIDDM Subjects

1996

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“…Remissions in Type 2 diabetic patients independent of weight loss have been noted for many years[17–23]. Good glycaemic control that had been achieved by chronic sulphonylurea therapy was maintained by placebo treatment and diet for periods of several months to several years[18,19].…”

Section: Discussionmentioning

confidence: 99%

Near‐normoglycaemic remission in African‐Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function

et al. 2001

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Forty-two per cent of newly diagnosed, unselected African-Americans with Type 2 diabetes, treated intensively using pharmacological agents, education and diet developed near-normoglycaemic remission. Remission was associated with a greater recovery of glucose-stimulated insulin secretion suggesting that therapies directed at promoting beta cell recovery and preservation are potentially useful approaches to the treatment of Type 2 diabetes mellitus.

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“…In addition, the duration of glucosuria and the mean insulin requirement determined the duration of the partial remission phase. Thus it appears, that the severity of the metabolic decompensation at the time of diagnosis, characterized by the duration of the disease [3], the blood glucose [6], the hemoglobin Alc-Concentration [5], the duration of glucosuria and the mean insulin requirement to induce the partial remission, predict the duration of the remission. It should be emphasized, that strict treatment after diagnosis to rapidly normalize the deteriorated carbohydrate and lipid metabolism is of utmost importance for the prognosis of the diabetic insulindependent patients [7].…”

Section: Discussionmentioning

confidence: 96%

“…Factors which predispose patients to enter the remission phase are short duration of the disease, relatively low initial fasting and postprandial blood sugar concentrations and a low insulin requirement [3,6]. Strict treatment with the "artificial beta cell" and rapid normalisation of the blood glucose may prolong the remission phase [7].…”

Section: Introductionmentioning

confidence: 99%

Relation between the degree of initial metabolic decompensation and the duration of the remission phase in type I diabetes mellitus

et al. 1982

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In 21 newly diagnosed children with type 1 diabetes mellitus initial hemoglobin A1c-concentrations, mean insulin requirements during the first 10 days of treatment to recompensate carbohydrate metabolism, duration of glucosuria after diagnosis and duration of remission were determined. Initial hemoglobin A1c-concentration and both mean insulin requirement during the first 10 days of treatment and duration of initial glucosuria showed a highly significant positive correlation. A highly significant, negative correlation was found between the duration of remission and both the mean insulin requirement during the first 10 days of treatment and the duration of initial glucosuria. Thus the present results together with previous findings suggest that the severity of initial metabolic decompensation in diabetes mellitus type I seems to determine at least in part the duration of remission.

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Remission in Diabetes

Cited by 7 publications

References 124 publications

Long-Term Normoglycemic Remission in Black Newly Diagnosed NIDDM Subjects

Long-Term Normoglycemic Remission in Black Newly Diagnosed NIDDM Subjects

Near‐normoglycaemic remission in African‐Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function

Relation between the degree of initial metabolic decompensation and the duration of the remission phase in type I diabetes mellitus

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