| Title |
Relapsing/remitting type 1 diabetes
|
|---|---|
| Published in |
Diabetologia, August 2017
|
| DOI | 10.1007/s00125-017-4403-3 |
| Pubmed ID | |
| Authors |
Kayleigh M. van Megen, Matthew P. Spindler, Fleur M. Keij, Ineke Bosch, Fleur Sprangers, Annet van Royen-Kerkhof, Tatjana Nikolic, Bart O. Roep |
| Abstract |
Type 1 diabetes is believed to be an autoimmune disease associated with irreversible loss of insulin secretory function that follows a chronic progressive course. However, it has been speculated that relapsing/remitting disease progression may occur in type 1 diabetes. We report the case of an 18-year-old girl with Graves' disease, chronic inflammatory demyelinating polyneuropathy (CIDP) and multiple islet autoantibodies, presenting with relapsing/remitting hyperglycaemia. Peripheral blood mononuclear cells were analysed for islet autoimmunity. There were two instances of hyperglycaemia relapse during CIDP flare-ups that required insulin therapy and remitted after i.v. immunoglobulin (IVIG) therapy improving neurological symptoms. A diagnosis of type 1 diabetes was assigned on the basis of insulin need, HbA1c and islet autoantibodies. Insulin requirements disappeared following IVIG treatment and peaked during CIDP flare-ups. Pro- and anti-inflammatory cytokine responses were noted against islet autoantigens. We provide clinical evidence of relapsing/remitting type 1 diabetes associated with IVIG treatment and the regulation of islet autoimmunity. Despite sufficient residual beta cell mass, individuals can experience episodes of impaired glycaemia control. This disconnect between beta cell mass and function highlighted by our case may have implications for the use of beta cell function as the primary endpoint for immune intervention trials aiming to protect beta cell mass rather than function. Immune modulation may restore beta cell function and glycaemic control. |
X Demographics
The data shown below were collected from the profiles of 23 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 6 | 26% |
| France | 3 | 13% |
| United States | 2 | 9% |
| Germany | 1 | 4% |
| Serbia | 1 | 4% |
| Spain | 1 | 4% |
| Italy | 1 | 4% |
| Belgium | 1 | 4% |
| Hungary | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 6 | 26% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 16 | 70% |
| Scientists | 5 | 22% |
| Practitioners (doctors, other healthcare professionals) | 2 | 9% |
Mendeley readers
The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 52 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 19% |
| Student > Bachelor | 8 | 15% |
| Student > Ph. D. Student | 8 | 15% |
| Student > Master | 3 | 6% |
| Student > Postgraduate | 2 | 4% |
| Other | 6 | 12% |
| Unknown | 15 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 25% |
| Biochemistry, Genetics and Molecular Biology | 5 | 10% |
| Immunology and Microbiology | 4 | 8% |
| Nursing and Health Professions | 3 | 6% |
| Neuroscience | 3 | 6% |
| Other | 7 | 13% |
| Unknown | 17 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 November 2023.
All research outputs
#2,687,018
of 24,717,692 outputs
Outputs from Diabetologia
#1,369
of 5,288 outputs
Outputs of similar age
#49,307
of 321,940 outputs
Outputs of similar age from Diabetologia
#59
of 107 outputs
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