A ONE-YEAR STUDY OF NEWLY MANIFESTED TYPE -I DIABETES-MELLITUS UNDER TIGHT GLUCOSE CONTROL

We wanted to evaluate residual insulin in newly manifested type-1 diab etics after one year of intensive insulin treatment. Nine adults (medi an 30.8 yrs) and six children (6.4 yrs) were included into the study. Control parameters were body weight, daily insulin, self-monitored blo od glucose levels, HbA1c, glucagon stimulated C-peptide, islet cell an tibodies (ICA) and insulin antibodies. Peripheral blood mononuclear ce lls were separated by Ficoll gradient and injected into CD-1 nu/nu mic e. Mouse pancreas was subsequently examined for inflammatory infiltrat ion of islets of Langerhans (insulitis). 6/9 (66%) adults were ICA pos itive, 2/9 (22%) had insulin autoantibodies. In 5 out of 7 (71%) cases human mononuclear cells caused pancreatic insulitis in the nude mice. After one year of intensive insulin therapy HbA1c was in the normal r ange. Glucagon stimulated C-peptide had increased by 80% from baseline in the adult patients. This increase was comparable to the effect of immunsuppressants like cyclosporin A. By contrast, no glucagon stimula ted C-peptide improvement was found in the children after one year.