Remission phase, endogenous insulin secretion and metabolic control in diabetic children.

Abstract

The occurrence and duration of clinical remission were analyzed in 173 diabetic children. One hundred and twelve (65%) children experienced a remission, which was complete in only five (3%) cases. Duration varied from one month to three years, the mean being 8.5 months. Boys showed a more frequent and longer remission phase (p less than 0.01) than girls. Children with a negative remission history were younger (p less than 0.05) at the onset of diabetes than children having remission periods. Duration of remission correlated positively with age at onset (rs = 0.19; p less than 0.01) and the non-fasting serum C-peptide concentration (rs = 0.31; p less than 0.001). There was a negative correlation between duration of remission and daily insulin dose (r = -0.23; p less than 0.005). We found no correlation between duration of remission and duration of diabetes or hemoglobin A1 (HbA1) concentrations beyond the remission period. Serum C-peptide concentrations correlated negatively with HbA1 levels (rs = -0.23; p less than 0.001) indicating that residual B-cell function favors good metabolic control. There was a negative correlation between HbA1 concentration and duration of diabetes (r= -0.30; p less than 0.001). Clinical remission of long duration is associated with persisting endogenous insulin secretion, and reduced daily insulin requirement, but its favorable effect on metabolic control beyond the remission period is questionable.