Complete Long-Term Recovery of β-Cell Function in Autoimmune Type 1 Diabetes After Insulin Treatment

Progressive loss of β-cell mass in type 1 diabetes results from CD4+ and CD8+ T-cell autoimmunity targeting insulin and other islet cell antigens. After initial treatment of type 1 diabetes, partial disease remission is found in 18–80% of patients, with a mean duration of only 6–10 months (1). A 13-year-old Caucasian boy (BMI 26.4 kg/m2) presented with 3 weeks’ history of polyuria, polydipsia, and weight loss. His serum glucose (26.8 mmol/l), HbA1c (9.4%, normal 3.2–5.5) and fructosamine (628 μmol/l, normal 205–285) levels were highly elevated (Fig. 1), and urinalysis showed glucosuria (+++) and ketonuria (+++). He was HLA-DRB1\*0101,\*0901, DRB4*01, DQA1*0101,03, and DQB1*0303,0501. Plasma C-peptide, determined at a blood glucose …