Department of Pediatrics, Bakırkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.
Department of Pediatric Metabolic Diseases, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
J Med Virol. 2020 Dec;92(12):2955-2960. doi: 10.1002/jmv.25734. Epub 2020 Mar 5.
We aimed to identify the determinants of partial remission in patients with type 1 diabetes mellitus (DM), and whether there is an influence of vaccination against measles on partial remission. This was a retrospective study consisting of consecutive patients diagnosed with type 1 DM followed-up from 1 September 2010, through 30 November 2011. The study included children vaccinated within 3 months after diagnosis, and children unvaccinated during the first 12 months of the disease. The daily insulin dose, hemoglobin A1c, and C-peptide levels, and whether children are in partial remission based on the insulin dose-adjusted HbA1c were recorded at diagnosis and 3, 6, 9, 12, 24, and 36 months. A total of 55 children with type 1 DM were analyzed. Thirty-one patients (56.4%) reached partial remission during the follow-up period, whereas 24 of them did not. Patients with diabetic ketoacidosis (DKA) at diagnosis were less likely to reach partial remission than patients without DKA (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.062-0.946; P = .038). Patients vaccinated against measles were more likely to be in partial remission than patients unvaccinated (OR, 4.2; 95% CI, 1.35-13; P = .011). Partial remission was significantly associated with the C-peptide level and insulin dosage at diagnosis P = .002; P = .013, respectively). The lack of DKA, higher C-peptide level, and lower insulin dosage at diagnosis, and vaccination against measles after diagnosis may have an influence on partial clinical remission in patients with new-onset type 1 DM.
我们旨在确定 1 型糖尿病(DM)患者部分缓解的决定因素,以及麻疹疫苗接种是否对部分缓解有影响。这是一项回顾性研究,纳入了 2010 年 9 月 1 日至 2011 年 11 月 30 日期间连续确诊的 1 型 DM 患者。研究包括诊断后 3 个月内接种疫苗的儿童,以及疾病最初 12 个月内未接种疫苗的儿童。在诊断时以及 3、6、9、12、24 和 36 个月时记录每日胰岛素剂量、糖化血红蛋白(HbA1c)和 C 肽水平,以及根据胰岛素剂量调整的 HbA1c 评估患儿是否处于部分缓解。共分析了 55 例 1 型 DM 患儿。31 例(56.4%)患儿在随访期间达到部分缓解,24 例未达到部分缓解。与无糖尿病酮症酸中毒(DKA)的患儿相比,诊断时有 DKA 的患儿更不易达到部分缓解(比值比 [OR],0.24;95%置信区间 [CI],0.062-0.946;P = .038)。接种麻疹疫苗的患儿更易达到部分缓解(OR,4.2;95% CI,1.35-13;P = .011)。部分缓解与诊断时的 C 肽水平和胰岛素剂量显著相关(P = .002;P = .013)。初诊时无 DKA、C 肽水平较高、胰岛素剂量较低,以及诊断后接种麻疹疫苗可能会影响新诊断的 1 型 DM 患者的部分临床缓解。