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Question:

From Czechoslavakia:

We learned two months ago about diabetes Type 1 of our 3-year old daughter. It is very hard for us to accept the fact that she will from the remission stage slowly drop down to zero beta cells. It is very upsetting to end up just with injections of insulin.

  • Is there any chance to prolong her period of remission?
  • Is there known any case of complete recovery from diabetes Type 1 up till now?
  • What are the most important steps in the prevention from the late complications of diabetes (besides the common facts like to keep her blood sugar level, etc.)?
  • Is it true that 50% of children with diabetes will die 35 years after the disease has started?

Answer:

I completely understand your frustration at not being able to save remaining insulin making beta cells. All parents ask why we can't stop the process of damage. The fact is that, since we don't fully understand the cause of the damage in the first place, it is very difficult to halt it. There have been studies with drugs that suppress the immune system (which is responsible for the damage) but, although they do work to some extent, as soon as they are stopped there is a rebound. In addition, and more seriously, the drugs that work are themselves dangerous and can cause kidney damage etc. The work is continuing in this area.

I think that the best way to come to terms with this is to realise that the dose of insulin that your daughter requires is irrelevant. She has diabetes and needs insulin injections no matter how much her own beta cells make. As she gets bigger you will need to give her more insulin and this would be true even if the remaining beta cells continued to work.

True insulin dependent diabetes is still incurable because the insulin producing cells are irreversibly damaged.

The good news is about the mortality figures that you quoted. All such figures are inevitably old because you have to wait 35 years before you know. There is no doubt that in the last 10-15 years the health of people with diabetes has improved. This is shown by the reduction in kidney problems especially. The outlook for your daughter is certainly going to be a lot better than for someone developing the disease 35 years ago.

KJR

Original posting 8 Jul 96

  
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Last Updated: Tuesday April 06, 2010 15:08:52
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