Buschard Karsten, Holm Laurits J, Feldt-Rasmussen Ulla
The Bartholin Institute, Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Case Rep Med. 2020 May 14;2020:6865190. doi: 10.1155/2020/6865190. eCollection 2020.
A 19-year-old girl was diagnosed with type 1 diabetes and showing polydipsia and polyuria. She was double autoantibody-positive and had a diabetes-prone tissue type. She was immediately started on insulin. Fenofibrate treatment (160 mg daily) was initiated seven days after diagnosis. The need for insulin quickly declined, and she took her last dose of insulin 19 days after the first dose of fenofibrate, having regained endogenous control of blood glucose concentrations. She has now been insulin independent for one year and 9 months. Unstimulated C-peptide has increased by 51% (317 to 479 pmol/l), and IA-2 autoantibody level has decreased by 65% (49 to 17 × 10 arbitrary units). Fenofibrate is a widely used drug for reducing triglyceride and cholesterol levels. Fenofibrate reverses and prevents autoimmune diabetes in nonobese diabetic (NOD) mice by increasing the amount of the sphingolipid sulfatide in islets. Sphingolipid metabolism is otherwise abnormal in the islets at diagnosis of type 1 diabetes. In conclusion, we describe a 19-year-old patient with classical newly diagnosed type 1 diabetes, which following fenofibrate treatment has been without insulin for 21 months.
一名19岁女孩被诊断为1型糖尿病，出现多饮和多尿症状。她双自身抗体呈阳性，具有糖尿病易患组织类型。她立即开始接受胰岛素治疗。在诊断后七天开始使用非诺贝特治疗（每日160毫克）。对胰岛素的需求迅速下降，在服用第一剂非诺贝特19天后，她服用了最后一剂胰岛素，血糖浓度恢复了内源性控制。她现在已经停用胰岛素一年零九个月了。未刺激的C肽增加了51%（从317升至479皮摩尔/升），IA-2自身抗体水平下降了65%（从49降至17×10任意单位）。非诺贝特是一种广泛用于降低甘油三酯和胆固醇水平的药物。非诺贝特通过增加胰岛中鞘脂硫苷脂的量来逆转和预防非肥胖糖尿病（NOD）小鼠的自身免疫性糖尿病。在1型糖尿病诊断时，胰岛中的鞘脂代谢在其他方面是异常的。总之，我们描述了一名19岁新诊断为经典1型糖尿病的患者，在接受非诺贝特治疗后已停用胰岛素21个月。
