Introduction: Newly diagnosed type 1 diabetes is characterized by a transient partial remission period (honeymoon), starting shortly after initiation of insulin treatment and during which the patients requirement for exogenous insulin treatment declines. Improvement of peripheral insulin sensitivity as well as a partial beta-cell recovery with improved insulin secretion was speculating to contribute to the pathogenesis of this phenomenon.
Case: We describe a case of 18 year-old boy who was diagnosed with diabetes following a 2 week-history of polyuria and polydipsia at the age of 12 years and was commenced on insulin. His HbA1c on diagnosis was 76 mmol/mol and GAD antibodies were detected consistent with a diagnosis of type 1 diabetes. His diabetes was well managed with mean HbA1c of 51 mmol/mol on minimum insulin requirements of 0.4 units/kg per day over the following 6 years indicating unusually prolonged partial permission phase. He underwent further genetic investigations for MODY which were negative. However, his urine C-peptide/creatinine ratio was 0.91 nmol/mmol indicating preserved endogenous insulin secretion.
Conclusion: We present an 18-year-old adolescent, diagnosed at 12 years of age with type 1 diabetes, with spontaneous and partial remission sustained for more than 6 years. It is well documented that the residual β-cell function remained highest in the age-group of 1015 years and this finding is comparable to our case. However further studies are required to determine which factors contribute to the partial and transient remission of type 1 diabetes in paediatric population.
27 - 29 Nov 2019
British Society for Paediatric Endocrinology and Diabetes