Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1999 Apr;80(4):367–369. doi: 10.1136/adc.80.4.367

Partial remission phase of diabetes in children younger than age 10 years

B Muhammad 1, P Swift 1, N Raymond 1, J Botha 1
PMCID: PMC1717883  PMID: 10086946

Abstract

There is renewed interest in the phase of partial remission in recently diagnosed diabetes because of the potential for pharmacological and immune intervention to preserve β cell function. 95 children younger than 10 years were investigated to assess the influence of age, sex, diabetic ketoacidosis (DKA), admission at diagnosis, and ethnicity on the frequency of remission and insulin requirements during the first two years after diagnosis. Partial remission was defined as a requirement of insulin < 0.5 U/kg body weight/day. There was partial remission in 41 patients, with no differences for children aged 2-4 years and those aged 5-9 years. None of the five children aged < 2 years remitted. Forty five of 95 children were admitted to hospital at diagnosis, of whom 26 of 45 had DKA (blood pH < 7.25). In this number of children we were unable to show a statistical difference in the rate of remission with respect to DKA, admission to hospital at diagnosis, sex, or South Asian ethnic background. There were no differences in insulin requirements between the different groups by the end of two years and at that time seven of the children required insulin < 0.5 U/kg/day. The results suggest that even in preschool children there is potential for attempting to preserve β cell function.



Full Text

The Full Text of this article is available as a PDF (112.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agner T., Damm P., Binder C. Remission in IDDM: prospective study of basal C-peptide and insulin dose in 268 consecutive patients. Diabetes Care. 1987 Mar-Apr;10(2):164–169. doi: 10.2337/diacare.10.2.164. [DOI] [PubMed] [Google Scholar]
  2. Baker L., Kaye R., Root A. W. The early partial remission of juvenile diabetes mellitus. The roles of insulin and growth hormone. J Pediatr. 1967 Dec;71(6):825–831. doi: 10.1016/s0022-3476(67)80007-6. [DOI] [PubMed] [Google Scholar]
  3. Charron-Prochownik D., Maihle T., Siminerio L., Songer T. Outpatient versus inpatient care of children newly diagnosed with IDDM. Diabetes Care. 1997 Apr;20(4):657–660. doi: 10.2337/diacare.20.4.657. [DOI] [PubMed] [Google Scholar]
  4. Daneman D., Knip M., Kaar M. L., Sochett E. Comparison of children with type 1 (insulin-dependent) diabetes in northern Finland and southern Ontario: differences at disease onset. Diabetes Res. 1990 Jul;14(3):123–126. [PubMed] [Google Scholar]
  5. Jefferson I. G., Smith M. A., Baum J. D. Insulin dependent diabetes in under 5 year olds. Arch Dis Child. 1985 Dec;60(12):1144–1148. doi: 10.1136/adc.60.12.1144. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Keller R. J., Eisenbarth G. S., Jackson R. A. Insulin prophylaxis in individuals at high risk of type I diabetes. Lancet. 1993 Apr 10;341(8850):927–928. doi: 10.1016/0140-6736(93)91215-8. [DOI] [PubMed] [Google Scholar]
  7. Knip M., Ilonen J., Mustonen A., Akerblom H. K. Evidence of an accelerated B-cell destruction in HLA-Dw3/Dw4 heterozygous children with type 1 (insulin-dependent) diabetes. Diabetologia. 1986 Jun;29(6):347–351. doi: 10.1007/BF00903342. [DOI] [PubMed] [Google Scholar]
  8. Knip M., Säkkinen A., Huttunen N. P., Kär M. L., Länkelä S., Mustonen A., Akerblom H. K. Postinitial remission in diabetic children--an analysis of 178 cases. Acta Paediatr Scand. 1982 Nov;71(6):901–908. doi: 10.1111/j.1651-2227.1982.tb09546.x. [DOI] [PubMed] [Google Scholar]
  9. Komulainen J., Lounamaa R., Knip M., Kaprio E. A., Akerblom H. K. Ketoacidosis at the diagnosis of type 1 (insulin dependent) diabetes mellitus is related to poor residual beta cell function. Childhood Diabetes in Finland Study Group. Arch Dis Child. 1996 Nov;75(5):410–415. doi: 10.1136/adc.75.5.410. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Ludvigsson J., Heding L. G. beta-cell function in children with diabetes. Diabetes. 1978;27 (Suppl 1):230–234. doi: 10.2337/diab.27.1.s230. [DOI] [PubMed] [Google Scholar]
  11. Matthews J. N., Altman D. G., Campbell M. J., Royston P. Analysis of serial measurements in medical research. BMJ. 1990 Jan 27;300(6719):230–235. doi: 10.1136/bmj.300.6719.230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Mirouze J., Selam J. L., Pham T. C., Mendoza E., Orsetti A. Sustained insulin-induced remissions of juvenile diabetes by means of an external artificial pancreas. Diabetologia. 1978 Apr;14(4):223–227. doi: 10.1007/BF01219420. [DOI] [PubMed] [Google Scholar]
  13. Schnell O., Eisfelder B., Standl E., Ziegler A. G. High-dose intravenous insulin infusion versus intensive insulin treatment in newly diagnosed IDDM. Diabetes. 1997 Oct;46(10):1607–1611. doi: 10.2337/diacare.46.10.1607. [DOI] [PubMed] [Google Scholar]
  14. Shah S. C., Malone J. I., Simpson N. E. A randomized trial of intensive insulin therapy in newly diagnosed insulin-dependent diabetes mellitus. N Engl J Med. 1989 Mar 2;320(9):550–554. doi: 10.1056/NEJM198903023200902. [DOI] [PubMed] [Google Scholar]
  15. Tarn A. C., Smith C. P., Spencer K. M., Bottazzo G. F., Gale E. A. Type I (insulin dependent) diabetes: a disease of slow clinical onset? Br Med J (Clin Res Ed) 1987 Feb 7;294(6568):342–345. doi: 10.1136/bmj.294.6568.342. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Veijola R., Knip M., Reijonen H., Vähäsalo P., Puukka R., Iionen J. Effect of genetic risk load defined by HLA-DQB1 polymorphism on clinical characteristics of IDDM in children. Eur J Clin Invest. 1995 Feb;25(2):106–112. doi: 10.1111/j.1365-2362.1995.tb01534.x. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES