Normal weight promotes remission and low number of islet antibodies prolong the duration of remission in Type 1 diabetes.
OBJECTIVE
To identify clinical, immunological and biochemical factors that predict remission, and its duration in a large cohort of young adults with Type 1 diabetes mellitus (DM).


METHODS
In Sweden, 362 patients (15-34 years), classified as Type 1 DM were included in a prospective, nation-wide population-based study. All patients were followed at local hospitals for examination of HbA(1c) and insulin dosage over a median period after diagnosis of 5 years. Duration of remission, defined as an insulin maintenance dose </= 0.3 U/kg/24 h and HbA(1c) within the normal range, was analysed in relation to characteristics at diagnosis.


RESULTS
Remissions were seen in 43% of the patients with a median duration of 8 months (range 1-73). Sixteen per cent had a remission with a duration > 12 months. Among patients with antibodies (ab(+)), bivariate analysis suggested that adult age, absence of low BMI, high plasma C-peptide concentrations, lack of ketonuria or ketoacidosis at diagnosis and low insulin dose at discharge from hospital were associated with a high possibility of achieving remission. Multiple regression showed that normal weight (BMI of 20-24.9 kg/m(2)) was the only factor that remained significant for the possibility of entering remission. In survival analysis among ab(+) remitters, a low number of islet antibodies, one or two instead of three or four, were associated with a long duration of remissions.


CONCLUSIONS
In islet antibody-positive Type 1 DM, normal body weight was the strongest factor for entering remission, whilst a low number of islet antibodies was of importance for the duration.
Schölin
A
A
Department of Medical Research 2, University Hospital, Entrance 70-3rd Floor, SE-751 85 Uppsala, Sweden. Anna.Scholin@medsci.uu.se
Törn
C
C
Nyström
L
L
Berne
C
C
Arnqvist
H
H
Blohmé
G
G
Bolinder
J
J
Eriksson
J W
JW
Kockum
I
I
Landin-Olsson
M
M
Ostman
J
J
Karlsson
F A
FA
Sundkvist
G
G
Björk
E
E
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015992:Body Mass Index; D001835:Body Weight; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007515:Islets of Langerhans / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012074:Remission Induction; D016019:Survival Analysis; D013997:Time Factors
D001323:Autoantibodies; D007004:Hypoglycemic Agents; D007328:Insulin