RESIDUAL BETA-CELL FUNCTION AND SPONTANEOUS CLINICAL REMISSION IN TYPE-1 DIABETES-MELLITUS - THE ROLE OF PUBERTY

To investigate the role of puberty on spontaneous clinical remission a nd on secretion of residual C-peptide during the first year of type 1 diabetes mellitus, we studied 77 pre-pubertal, 39 pubertal and 41 post -pubertal type 1 diabetic patients. Spontaneous partial clinical remis sion (HbA(1c) within the normal range and insulin dose less than 0.3 U .kg(-1) body weight.day(-1) lasting for at least 10 days) decreased wi th duration of diabetes: months 3 vs 6 vs 12, respectively 13 vs 7 vs 4% (P<0.025). Remission was higher in post-pubertal than pubertal and prepubertal patients: month 6 respectively 20 vs 5 vs 1% (P<0.001). Se cretion of C-peptide was significantly lower in pre-pubertal than the other two groups of patients. Basal and stimulated C-peptide secretion were higher in patients in clinical remission than in those who were not: basal value 0.4 (0.26-0.53) vs 0.28 (0.14-0.4) nmol/l (P<0.05); s timulated value 0.63 (0.5-0.95) vs 0.56 (0.31-0.74) nmol/l (P<0.05). S pontaneous remission is less frequent in children and adolescent patie nts than in adult post-pubertal patients, but different mechanisms may be involved. Low residual insulin secretion seems implicated in child ren meanwhile low insulin sensitivity could be more important in puber tal patients.