Effect of two periods with intensified insulin treatment on B-cell function during the first 18 months of type 1 (insulin-dependent) diabetes mellitus.

Fifteen consecutive type 1 (insulin-dependent) diabetics were randomized within 24 hrs of diagnosis of the disease into two groups for treatment: group A (N = 9) was treated conventionally with one or two daily doses of insulin, group B (N = 6) was treated with nine daily injections of fast-acting insulin for ten days after diagnosis and for 7 days after 15 months duration of diabetes. For remaining time group B was treated conventionally like group A. The mean diurnal blood glucose concentration during the initial ten days of insulin treatment was 11.7 +/- 0.5 mmol/l (mean +/- SEM) in group A and 6.4 +/- 0.3 mmol/l in group B (P less than 0.01) and 6.0 +/- 0.3 mmol/l in group B during the 7 days with intensified treatment 15 months later. B-cell function was assessed from the C-peptide response to a standard meal 17 and 14 days and 3, 6, 9, 12, 15 and 18 months after start of insulin treatment. After 14 days the C-peptide response was significantly higher (60%) in group B than in group A (P less than 0.05). The second period with strict control improved B-cell function in 4 out of 5 patients with B-cell function. At no test other than after 14 days was there any difference in B-cell function between the groups. Short-term improvement of glycaemic control at onset of disease and after the remission period seem without effect on the long-term outcome of B-cell function in type 1 (insulin-dependent) diabetics.

RCT Entities:   Population Interventions Outcomes