Tags

Type your tag names separated by a space and hit enter

Glucose evaluation trial for remission (GETREM) in type 1 diabetes: a European multicentre study.
Diabetes Res Clin Pract. 2005 Jun; 68(3):258-64.DR

Abstract

OBJECTIVE

Strict metabolic control during the 1st year of type 1 diabetes is thought to be a key factor for achieving clinical remission. The aims of this study were two-fold: (i) to evaluate the frequency and duration of spontaneous remission (defined according to the parameters issued by the International Diabetic Immunotherapy Group (IDIG)) in a European population of consecutive recent onset type 1 diabetes patients (aged 5-35 years), followed-up for a period of 36 months with a common protocol of intensive insulin therapy and without adjunct immune-intervention; and (ii) to identify the predictive factors for clinical remission.

RESEARCH DESIGN AND METHOD

A total of 189 consecutive patients with newly diagnosed type 1 diabetes according to ADA criteria were recruited in participating centres (Belgium, Czech Republic, Estonia, France, Germany, Hungary, Italy, Poland, Romania, Sweden and Turkey) and followed-up for a period of up to 36 months. In all patients, intensive insulin therapy was implemented consisting of three or four injections of regular insulin daily with NPH insulin at bedtime. Adjustment of insulin dose was made according to a common protocol. Various clinical characteristics (age, gender, severity of presentation, etc.), history (presence of diabetic siblings in the family, etc.) and integrated parameters of metabolic control (HbA(1c), blood glucose, the total insulin dose at hospital discharge adjusted for body weight) were collected.

RESULTS

Twenty-two patients (11.6%) experienced remission. The median duration of remission was 9.6 months and the range was 31 months. There was a wide variation among centres. Logistic regression analysis focused on the centre as the main variable in achieving remission.

CONCLUSION

Remission was shown to be very heterogeneous between centres depending on 'other factors' such as patient care and family awareness of the disease rather than on 'measurable factors' such as sex, age, HbA(1c) and severity of presentation at diagnosis. Using intensive insulin therapy and optimisation of metabolic control, remission occurred in nearly one out of eight patients.

Authors+Show Affiliations

Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via E. Longoni, 83, 00155 Rome, Italy. pozzilli@unicampus.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15936469

Citation

Pozzilli, P, et al. "Glucose Evaluation Trial for Remission (GETREM) in Type 1 Diabetes: a European Multicentre Study." Diabetes Research and Clinical Practice, vol. 68, no. 3, 2005, pp. 258-64.
Pozzilli P, Manfrini S, Buzzetti R, et al. Glucose evaluation trial for remission (GETREM) in type 1 diabetes: a European multicentre study. Diabetes Res Clin Pract. 2005;68(3):258-64.
Pozzilli, P., Manfrini, S., Buzzetti, R., Lampeter, E., Leeuw, I. D., Iafusco, D., Prisco, M., Ionescu-Tirgoviste, C., Kolouskovà, S., Linn, T., Ludvigsson, J., Madàcsy, L., Mrozikiewicz, A. S., Mrozikiewicz, P. M., Podar, T., Vavrinec, J., Vialettes, B., Visalli, N., Yilmaz, T., & Browne, P. D. (2005). Glucose evaluation trial for remission (GETREM) in type 1 diabetes: a European multicentre study. Diabetes Research and Clinical Practice, 68(3), 258-64.
Pozzilli P, et al. Glucose Evaluation Trial for Remission (GETREM) in Type 1 Diabetes: a European Multicentre Study. Diabetes Res Clin Pract. 2005;68(3):258-64. PubMed PMID: 15936469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glucose evaluation trial for remission (GETREM) in type 1 diabetes: a European multicentre study. AU - Pozzilli,P, AU - Manfrini,S, AU - Buzzetti,R, AU - Lampeter,E, AU - Leeuw,I De, AU - Iafusco,D, AU - Prisco,M, AU - Ionescu-Tirgoviste,C, AU - Kolouskovà,S, AU - Linn,T, AU - Ludvigsson,J, AU - Madàcsy,L, AU - Mrozikiewicz,A Seremak, AU - Mrozikiewicz,P M, AU - Podar,T, AU - Vavrinec,J, AU - Vialettes,B, AU - Visalli,N, AU - Yilmaz,T, AU - Browne,P D, AU - ,, Y1 - 2004/11/21/ PY - 2004/04/21/received PY - 2004/10/05/revised PY - 2004/10/06/accepted PY - 2005/6/7/pubmed PY - 2005/12/13/medline PY - 2005/6/7/entrez SP - 258 EP - 64 JF - Diabetes research and clinical practice JO - Diabetes Res Clin Pract VL - 68 IS - 3 N2 - OBJECTIVE: Strict metabolic control during the 1st year of type 1 diabetes is thought to be a key factor for achieving clinical remission. The aims of this study were two-fold: (i) to evaluate the frequency and duration of spontaneous remission (defined according to the parameters issued by the International Diabetic Immunotherapy Group (IDIG)) in a European population of consecutive recent onset type 1 diabetes patients (aged 5-35 years), followed-up for a period of 36 months with a common protocol of intensive insulin therapy and without adjunct immune-intervention; and (ii) to identify the predictive factors for clinical remission. RESEARCH DESIGN AND METHOD: A total of 189 consecutive patients with newly diagnosed type 1 diabetes according to ADA criteria were recruited in participating centres (Belgium, Czech Republic, Estonia, France, Germany, Hungary, Italy, Poland, Romania, Sweden and Turkey) and followed-up for a period of up to 36 months. In all patients, intensive insulin therapy was implemented consisting of three or four injections of regular insulin daily with NPH insulin at bedtime. Adjustment of insulin dose was made according to a common protocol. Various clinical characteristics (age, gender, severity of presentation, etc.), history (presence of diabetic siblings in the family, etc.) and integrated parameters of metabolic control (HbA(1c), blood glucose, the total insulin dose at hospital discharge adjusted for body weight) were collected. RESULTS: Twenty-two patients (11.6%) experienced remission. The median duration of remission was 9.6 months and the range was 31 months. There was a wide variation among centres. Logistic regression analysis focused on the centre as the main variable in achieving remission. CONCLUSION: Remission was shown to be very heterogeneous between centres depending on 'other factors' such as patient care and family awareness of the disease rather than on 'measurable factors' such as sex, age, HbA(1c) and severity of presentation at diagnosis. Using intensive insulin therapy and optimisation of metabolic control, remission occurred in nearly one out of eight patients. SN - 0168-8227 UR - https://www.unboundmedicine.com/medline/citation/15936469/Glucose_evaluation_trial_for_remission__GETREM__in_type_1_diabetes:_a_European_multicentre_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(04)00308-0 DB - PRIME DP - Unbound Medicine ER -