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骨化三醇和小剂量基础胰岛素维持 1 型糖尿病的长期临床缓解:病例报告。

Prolonged clinical remission of type 1 diabetes sustained by calcifediol and low-dose basal insulin: a case report.

机构信息

CTO Andrea Alesini Hospital, Division of Endocrinology & Diabetes, Department of Systems Medicine, University of Rome Tor Vergata, Via San Nemesio 21, Rome, 00145, Italy.

Division of Cellular Transplantation, Diabetes Research Institute (DRI), University of Miami Miller School of Medicine, 1450 NW 10th Ave, Miami, FL 33136, USA.

出版信息

Immunotherapy. 2023 Sep;15(13):1009-1019. doi: 10.2217/imt-2022-0266. Epub 2023 Jul 4.

Abstract

Herein, we describe an unusually prolonged duration (31 months) of the clinical remission phase in a 22-year-old Italian man with new-onset type 1 diabetes. Shortly after the disease diagnosis, the patient was treated with calcifediol (also known as 25-hydroxyvitamin D3 or calcidiol), coupled with low-dose basal insulin, to correct hypovitaminosis D and to exploit the anti-inflammatory and immunomodulatory properties of vitamin D. During the follow-up period, the patient retained a substantial residual β-cell function and remained within the clinical remission phase, as evidenced by an insulin dose-adjusted glycated hemoglobin value <9. At 24 months, we detected a peculiar immunoregulatory profile of peripheral blood cells, which may explain the prolonged duration of the clinical remission sustained by calcifediol as add-on treatment to insulin.

摘要

在此,我们描述了一位 22 岁的意大利新发 1 型糖尿病患者,其临床缓解期异常延长(31 个月)。在疾病诊断后不久,该患者接受了 calcifediol(也称为 25-羟维生素 D3 或 calcidiol)联合小剂量基础胰岛素治疗,以纠正维生素 D 缺乏症,并利用维生素 D 的抗炎和免疫调节特性。在随访期间,患者保留了相当大的残余β细胞功能,并保持在临床缓解期,这一点可通过胰岛素剂量调整后的糖化血红蛋白值<9 来证明。在 24 个月时,我们检测到外周血细胞的一种特殊的免疫调节谱,这可能解释了 calcifediol 作为胰岛素附加治疗的临床缓解期延长。

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