Summary
Remission of diabetes was attempted in 12 recent acute onset ketosis-prone juvenile diabetes after short term (5±1 days) but excellent blood glucose control by the external artificial beta-cell. The comparison group comprised patients undergoing traditional treatment (n=28). Nine (75%) persistent (over 3–14 months of duration) although partial (oral drugs required) remissions were obtained in the former group as compared to 3 (11%) in the latter group (p<0.05). Cases which showed remissions after insulin infusion had a plasma insulin response to IV glucagon still present before insulin infusion, and a daily urinary C-peptide excretion significantly enhanced after (p<0.01). Urinary C-peptide /blood glucose remained improved during the remission period. Thus, early effective treatment by means of the artificial pancreas may break the vicious circle hyperglycaemia-insulin depletion-hyperglycaemia and lead to frequent and sustained remissions of juvenile diabetes.
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Jackson, R.L., Boyd, J.D., Smith, R.E.: Stabilization of diabetic children. Am. J. Dis. Child.59, 332–341 (1940)
Brush, J.M.: Initial stabilization of diabetic children. Am. J. Dis. Child.67, 429–444 (1944)
Jackson, R.L., Onofrio, J., Waiches, H., Guthrie, R.A.: The “honeymoon period”: partial remission of juvenile diabetes mellitus. Diabetes20 (suppl. 1), 361 (1971)
Pirart, J., Lauvaux, J.P.: Remission in diabetes. In: E.F. Pfeiffer (Ed.): Handbook of diabetes mellitus, 2, 443–502. München: Lehmans Verlag 1972
Ludvigsson, J., Heding, L.G., Larsson, Y., Leander, E.: C-peptide in juvenile diabetics beyond the post initial period. Acta Paediatr. Scand.66, 177–184 (1977)
Harwood, R.: Severe diabetes with remission. N. Engl. J. Med.257, 257–261 (1957)
Mirouze, J., Selam, J.L., Pham, T.C.: Infusion insulinique par débit asservi à l'enregistrement glycémique continu. Journ. Annu. Diabetol. Hotel Dieu, 302–312. Paris: Flammarion 1976
Mirouze, J., Selam, J.L., Pham, T.C.: Evaluation of exogenous insulin homeostasis by the artificial pancreas in insulin dependent diabetics. Diabetologia13, 273–278 (1977)
Hales, C.N., Randle, P.J.: Immuno-assay of insulin with antibody precipitate. Biochem. J.88, 137 (1963)
Horwitz, D.L., Rubenstein, A.H., Katz, A. I.: Quantitation of human pancreatic beta cell function by immunoassay of C-peptide in urine. Diabetes26, 30–35 (1977)
Weber, B.: Glucose stimulated insulin secretion during “remission” of juvenile diabetes. Diabetologia8, 189–195 (1972)
Block, M.B., Rosenfield, R.L., Mako, M.E., Steiner, D.F., Rubenstein, A.H.: Sequential changes in beta-cell function in insulin treated diabetic patients assessed by C-peptide immunoreactivity. J. Clin. Endocrinol. Metab.35, 402–406 (1972)
Ludvigsson, J., Heding, L.G.: C-peptide in children with juvenile diabetes. Diabetologia12, 627–630 (1976)
Binder, C., Faber, O.K., Heding, L.G.: Plasma C-peptide response to glucagon as a measure of beta-cell function on insulin dependent diabetes mellitus. In: J.S. Bajaj (Ed.): Abstracts of the 9th Congress of the International Diabetes Federation, New Delhi, 22, Amsterdam: Excerpta Med. 1976
Chiumello, G., Del Guarcio, M.J., Bidone, G.: Effects of glucagon and tolbutamide on plasma insulin levels in children with ketoacidosis. Diabetes17, 133–135 (1968)
Genuth, S.M.: Clinical remission in diabetes mellitus. Diabetes19, 116–121 (1970)
Enk, B., Deckert, T.: Insulin secretion in insulin requiring diabetics before and during insulin treatment. Diabetologia11, 340 (1975)
Hernandes, A., Zorilla, E., Gershberg, H.: Serum insulin in remission of juvenile diabetes. Lancet1968 II, 223
Johansen, K., Ørskov, H.: Plasma insulin during remission in juvenile diabetes mellitus. Br. Med. J.1969 I, 676–678
Kosaka, K., Hagura, R., Saito, R., Rsukamoto, F., Kusuya, T.: Changes in plasma insulin and glucose tolerance in stable diabetes in a young woman. Diabetes18, 487–492 (1969)
Block, M.B., Mako, M.E., Steiner, D.F., Rubenstein, A.H.: Diabetic keto-acidosis: Evidence for C-peptide and proinsulin secretion following recovery. J. Clin. Endocrinol. Metab.35, 402–406 (1972)
Turner, R. C., McCarthy, S.T., Holman, R.R., Harris, E.: Beta-cell function improved by supplementing basal insulin secretion in mild diabetes. Br. Med. J.1976 I, 1252–1254
Holman, R.R., Turner, R.C.: Diabetes: the quest for basal normoglycaemia. Lancet1977 I, 469–474
Campbell, J., Haist, R.E., Ham, A.W., Best, C.H.: The insulin content of the pancreas as influenced by anterior pituitary extract and insulin. Am. J. Physiol.129, 328 (1940)
Zilker, Th., Ermler, R., Bottermann, P.: C-peptide secretion according to glucose and insulin levels. In: J.S. Bajaj (Ed.): Abstracts of the 9th Congress of the International Diabetes Federation, New Delhi, 31-32. Amsterdam: Excerpta Med. 1976
Hellerstrom, C., Andersonn, A., Gunnarsson, R.: Regeneration of islet cells. International Symposium on the Immunological aspects of diabetes mellitus. Acta Endocrinol. (Kbh.) [Suppl.]205, 145–158 (1975)
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Mirouze, J., Selam, J.L., Pham, T.C. et al. Sustained insulin-induced remissions of juvenile diabetes by means of an external artificial pancreas. Diabetologia 14, 223–227 (1978). https://doi.org/10.1007/BF01219420
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DOI: https://doi.org/10.1007/BF01219420