Abstract
The clinical course and pancreatic B-cell function of diabetics (males 7, females 3) newly diagnosed after the age of 25 years, were studied. Fifty g oral glucose tolerance tests (50 g OGTT) were performed before and after treatment, and the IRI (CPR) respons was measured at the same time.
Immediately after admission, intensive insulin therapy was begun and remission was obtained in 5 out of the 10 patients (males 3, females 2). The other 5 patients (males 4, female 1) wre continued on insulin therapy.
The patients who experienced remission had been overweight (24±2.3% of ideal body weight) before the onset of diabetes.
The fasting blood glucose (FBG) level on admission was 321±57 mg/dl and the IRI response to 50 g OGTT showed a low and flat pattern. Insulin therapy was discontinued when the FBG level fell 74±3 mg/dl. The maximum dosage for the insulin therapy was 28.8±6.4 U/day. At this point, bodyweight was normal (8.8±2%) and a marked elevation of the CPR response to 50 g OGTT was observed.
Two out of the 5 remission cases showed overt diabetes with insulin therapy over periods of 3 months and 1 year and 3 months, respectively. At this point, their CPR response to 50 g OGTT dropped to a low and flat pattern again.
The clinical pictures of the 5 patients without remission were similar to those of cases with remission except that the patients were not obese (10.2±3%) before the onset of diabetes and recovery of endogenous insulin response was not observed.
