Book Volume 7
Partial Remission (honeymoon phase) in Type 1 Diabetes Mellitus
Page: 1-20 (20)
Author: Sasigarn A. Bowden
Abstract
Partial remission (‘honeymoon’) phase in type 1 diabetes (T1D) is characterized by a decline in the need for exogenous insulin that starts shortly after the initiation of insulin therapy in newly diagnosed individuals. In some cases, the insulin dose requirement is greatly reduced to almost none while maintaining near normal glycemic control. Results from the Diabetes Control and Complication Trial indicate that preservation of residual β-cell function is associated with not only reduction of long-term clinical micro- and macro-vascular complication but also reduction of acute complications such as hypoglycemia or diabetic ketoacidosis. There has been a recent renewed interest in partial remission because it offers a unique opportunity for pharmacological intervention aiming to completely arrest further destruction process of the β-cells, or best to regenerate the β-cells and thus preserve endogenous insulin secretion. This review summarizes current knowledge on partial remission in T1D, how to define partial remission by clinical criteria and C-peptide measurements, reviews factors associated with partial remission, and provides an update on the interventions to preserve β-cell function to promote or prolong the partial remission phase.