Normal weight promotes remission and low number of islet antibodies prolong the duration of remission in Type 1 diabetes.
Scholin, A. *; Torn, C. +; Nystrom, L. ++++; Berne, C. *; Arnqvist, H. ++; Blohme, G. [S]; Bolinder, J. [P]; Eriksson, J. W. **; Kockum, I. ++; Landin-Olsson, M. +; Ostman, J. [P]; Karlsson, F. A. *; Sundkvist, G. [S][S]; Bjork, E. 1
[Article]
Diabetic Medicine.
21(5):447-455, May 2004.
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Aim: To identify clinical, immunological and biochemical factors that predict remission, and its duration in a large cohort of young adults with Type 1 diabetes mellitus (DM).
Methods: In Sweden, 362 patients (15-34 years), classified as Type 1 DM were included in a prospective, nation-wide population-based study. All patients were followed at local hospitals for examination of HbA1c and insulin dosage over a median period after diagnosis of 5 years. Duration of remission, defined as an insulin maintenance dose <= 0.3 U/kg/24 h and HbA1c within the normal range, was analysed in relation to characteristics at diagnosis.
Results: Remissions were seen in 43% of the patients with a median duration of 8 months (range 1-73). Sixteen per cent had a remission with a duration > 12 months. Among patients with antibodies (ab ), bivariate analysis suggested that adult age, absence of low BMI, high plasma C-peptide concentrations, lack of ketonuria or ketoacidosis at diagnosis and low insulin dose at discharge from hospital were associated with a high possibility of achieving remission. Multiple regression showed that normal weight (BMI of 20-24.9 kg/m2) was the only factor that remained significant for the possibility of entering remission. In survival analysis among ab remitters, a low number of islet antibodies, one or two instead of three or four, were associated with a long duration of remissions.
Conclusion: In islet antibody-positive Type 1 DM, normal body weight was the strongest factor for entering remission, whilst a low number of islet antibodies was of importance for the duration.
Copyright (C) 2004 Blackwell Publishing Ltd.