Abstract
Among 40 children with recent type 1 IDDM treated with cyclosporin A (CyA), 27 interrupted insulin injections 48 ± 5 days after the onset of therapy and thereafter maintained their HbA1C level below 7.5% [N: 4.8 ± 0.7 (sd)%]. We compared this group with the 13 patients who could not maintain such glucose control without insulin.
No differences were detected in terms of age (10.2 vs 9.8 yrs), sex, initial blood glucose (3.9 vs 5.1 g/l), presence of islet cell antibodies (ICA: 72 vs 80%; S-ICA: 84 vs 93%; CF-ICA: 60 vs 43%), insulin autoantibodies (36 vs 25%), DR3 (61 vs 77%), DR4 (74 vs 69%), DR3,4 (39 vs 46%).
Clearcut differences were observed for the duration of polyuria (27 vs 48 days, p < 0.01), weight loss (3.2 vs 10.1% BW, p < 0.001), ketoacidosis (11 vs 62%, p < 0.001) and C peptide response to iv glucagon (0.5 vs 0.1 nmol/l, p < 0.02). Mean CyA dose (8.3 mg kg−1 d−1) and 12 hr trough levels (RIA) in blood were similar (273 ng/ml vs 299 ng/ml) in both groups.
These data indicate that the early response to CyA depends primarily on the precocity of immunointervention and the persistence of sufficient beta cell function. Selection of patients based on these parameters should further increase the frequency of early remissions in future trials of immunosuppression in recent IDDM.
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Bougnéres, P., Carel, J., Castano, L. et al. PREDICTION OF EARLY REMISSION IN CYCLOSPORIN-TREATED RECENT TYPE 1 DIABETICS. Pediatr Res 23, 115 (1988). https://doi.org/10.1203/00006450-198801000-00082
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DOI: https://doi.org/10.1203/00006450-198801000-00082