scholarly journals Case Report: Markedly Long-Term Preservation of Pancreatic β‐Cell Function in a Subject With Elderly Onset of Type 1 Diabetes Mellitus Showing High-Titer Autoimmune Antibodies for Over 4 Years

2021 ◽  
Vol 12 ◽  
Author(s):  
Ryo Shigemoto ◽  
Takatoshi Anno ◽  
Fumiko Kawasaki ◽  
Kohei Kaku ◽  
Hideaki Kaneto
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Cell Function ◽  
Β Cell ◽  
Cell Destruction ◽  
Β Cell Function ◽  
Long Term Preservation

Type 1 diabetes mellitus (T1DM) is mainly triggered by autoimmune β-cell destruction, usually leading to absolute insulin deficiency. Regarding the speed of β-cell destruction, there are large variations depending on age. In some adult cases, sufficient β-cell function is sometimes retained for a relatively long period and eventually they become dependent on insulin for survival. It is known that even in subjects with T1DM showing high titers of such antibodies, insulin secretory capacity is preserved under several conditions such as “honeymoon” period and slowly progressive T1DM (SPIDDM). Herein, we reported the acute onset T1DM subject with long-term preservation of β-cell function, although his anti-GAD antibody and anti-IA-2 antibody titers were very high for more than 4 years. This case is very important in that his β-cell function was preserved with dipeptidyl peptidase-4 inhibitor alone. This means that there are large variations in the speed of β-cell destruction in the onset of T1DM.

scholarly journals Exercise to preserve β-cell function in recent-onset Type 1 diabetes mellitus (EXTOD) - a randomized controlled pilot trial

2017 ◽  
Vol 34 (11) ◽  
pp. 1521-1531 ◽  
Author(s):  
P. Narendran ◽  
N. Jackson ◽  
A. Daley ◽  
D. Thompson ◽  
K. Stokes ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Cell Function ◽  
Pilot Trial ◽  
Β Cell ◽  
Recent Onset ◽  
Randomized Controlled ◽  
Β Cell Function

scholarly journals Rate of β-Cell Destruction in Type 1 Diabetes Influences the Development of Diabetic Retinopathy: Protective Effect of Residual β-Cell Function for More Than 10 Years

2008 ◽  
Vol 93 (12) ◽  
pp. 4759-4766 ◽  
Author(s):  
Koji Nakanishi ◽  
Chizuru Watanabe
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Cell Function ◽  
Glycosylated Hemoglobin ◽  
Β Cell ◽  
Historical Cohort ◽  
Cell Destruction ◽  
Β Cell Function ◽  
Onset Of Diabetes

Context: Although residual β-cell function delays the onset and progression of diabetic retinopathy in patients with type 1 diabetes, the rate of β-cell destruction is variable. Objective: The aim of the study was to clarify the influence of the rate of β-cell destruction on the development and progression of diabetic retinopathy in type 1 diabetes. Design: We performed a historical cohort study regarding residual β-cell function and retinopathy. Setting: The study was conducted in the outpatient clinic of a general hospital. Patients: A total of 254 patients with type 1 diabetes participated. Main Outcome Measures: Serum C-peptide and fundus findings were evaluated longitudinally. Results: The cumulative incidence of mild nonproliferative diabetic retinopathy was higher in the patients without detectable β-cell function than in those with residual β-cell function at 20, 15, and 10 yr after the onset of diabetes (P = 0.013, P = 0.006, and P = 0.048, respectively), but not at 5 yr after the onset (P = 0.84). There were higher mean glycosylated hemoglobin values during the entire follow-up period in the patients without detectable β-cell function at 20 and 15 yr after the onset of diabetes (P = 0.030 and P = 0.042, respectively). Positivity for HLA-A24 and -DQA1*03, as well as the acute onset of diabetes, was associated with early β-cell loss and also with early development of diabetic retinopathy. Cox proportional hazards analysis showed that undetectable β-cell function at 20, 15, or 10 yr after the onset of diabetes was an independent risk factor for the development of diabetic retinopathy. Conclusions: Undetectable β-cell function within 10 yr of the onset of type 1 diabetes is associated with the earlier occurrence of diabetic retinopathy.

scholarly journals Residual β cell function in long-term type 1 diabetes associates with reduced incidence of hypoglycemia

2021 ◽  
Vol 131 (3) ◽  
Author(s):  
Rose A. Gubitosi-Klug ◽  
Barbara H. Braffett ◽  
Susan Hitt ◽  
Valerie Arends ◽  
Diane Uschner ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cell Function ◽  
Β Cell ◽  
Β Cell Function ◽  
Term Type

scholarly journals Effects of incretin-based therapies on β-cell function in type 1 diabetes mellitus: a systematic review and meta-analysis

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110663
Author(s):  
Yucheng Wu ◽  
Yu Lu ◽  
Shufang Yang ◽  
Qingqing Zhang
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Cell Function ◽  
Meta Analysis ◽  
Β Cell ◽  
C Peptide ◽  
Β Cell Function

Aim To assess the effects of incretin-based therapies on β-cell function in patients with type 1 diabetes mellitus (T1DM). Methods We searched the PubMed, Cochrane Library, Embase, and Web of Knowledge databases for eligible randomized clinical trials published up to July 2021. The inclusion criteria were patients with T1DM or latent autoimmune diabetes in adults, patients treated with dipeptidyl peptidase-4 inhibitors or glucagon like peptide-1 receptor agonists, and outcomes included one of the following: fasting plasma glucose, fasting C-peptide, postprandial C-peptide, C-peptide area under the curve (AUC), homeostasis model assessment for β cell function, and insulin resistance. The effects were analyzed using a random effect model with STATA 11.0. Results Eight trials including 427 participants were included in the final analysis. A pooled analysis found no significant difference in fasting plasma glucose, fasting C-peptide, postprandial C-peptide, or C-peptide AUC between patients treated with incretin-based therapies and placebo. The two trials that reported changes in 2-hour postprandial C-peptide and two of the four trials that reported changes in C-peptide AUC reported increases after incretin-based therapies. Conclusion This meta-analysis showed that incretin-based therapies did not preserve β-cell function in patients with T1DM.

scholarly journals Immunotherapy Strategies for the Prevention and Treatment of Distinct Stages of Type 1 Diabetes: An Overview

2020 ◽  
Vol 21 (6) ◽  
pp. 2103 ◽  
Author(s):  
Novella Rapini ◽  
Riccardo Schiaffini ◽  
Alessandra Fierabracci
Keyword(s):  
Type 1 Diabetes ◽  
Cell Function ◽  
Early Stage ◽  
Β Cell ◽  
Good Glycemic Control ◽  
Autoimmune Attack ◽  
Β Cell Function ◽  
Microvascular And Macrovascular Complications

Type 1 diabetes mellitus is a heterogeneous disorder characterized by destruction of pancreatic β cells, culminating in absolute insulin deficiency. The goals of Type 1 diabetes care, established by the Diabetes Control and Complications Trial (DCCT), are to achieve good glycemic control, to prevent hyperglycaemia (which is associated with long-term microvascular and macrovascular complications) and to avoid recurrent episodes of hypoglycaemia (which may have adverse effects on cognitive function). However, despite continuing optimization of insulin therapy regimes, the actual hormonal substitutive administration acts only to treat the symptoms without an effect on disease pathology and etiopathogenesis. In recent decades, a great deal of interest has been focused on prevention approaches in high-risk individuals, based on the hypothesis that a therapeutic intervention, if applied at the early stage of disease, might contribute to maintaining endogenous β cell function by preserving the residual β cell reservoir from autoimmune attack. This manuscript provides an overview of the most important immunotherapeutic interventions established so far for Type 1 diabetes treatment at different stages of disease that have reached an advanced stage of assessment.

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