The Use of Glipizide Combined with Intensive Insulin Treatment for the Induction of Remissions in New Onset Adult Type I Diabetes

Jl, Selam; Woertz, L; Lozano, J.; Robinson, Mary; Chan, Erwin; Ma, Charles

doi:10.3109/08916939309014647

Cited by 14 publications

(1 citation statement)

References 29 publications

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“…We found that this strategy is associated with improved β-cell function after termination of exogenous insulin using only sulfonylurea treatment, which, in 54% of subjects, resulted in insulin-free remissions, whereas without sulfonylurea 22% went into remission ( Fig. 1 C , blue arrows) ( 36 ). By implication, a certain resilience of the β-cell organ exists, likely due to the degree of β-cell content ( Fig.…”

Section: Pathophysiologymentioning

confidence: 93%

Diabetes: Concepts of β-Cell Organ Dysfunction and Failure Would Lead to Earlier Diagnoses and Prevention

Charles

Leslie

2021

Diabetes

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As the world endures a viral pandemic superimposed on a diabetes pandemic, the latter incorporates most of the comorbidities associated with the former, thereby exacerbating risk of death in both. An essential approach to both pandemics is prevention and unrealized earlier treatment. Thus, in this Perspective relating to diabetes, we emphasize a paradigm of, first, reversible β-cell organ dysfunction and then irreversible β-cell organ failure, which directly indicate the potential for earlier prevention, also unrealized in current guidelines. Four pillars support this paradigm: epidemiology, pathophysiology, molecular pathology, and genetics. A substantial worldwide knowledge base defines each pillar and informs a more aggressive preventive approach to most forms of the disorder. This analysis seeks to clarify the temporal and therapeutic relationships between lost β-cell function and content, illuminating the potential for earlier diagnoses and, thus, prevention. We also propose that myriad pathways leading to most forms of diabetes converge at the endoplasmic reticulum, where stress can result in β-cell death and content loss. Finally, genetic and nongenetic origins common to major types of diabetes can inform earlier diagnosis and, potentially, prevention, with the aim of preserving β-cell mass.

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Section: Pathophysiologymentioning

confidence: 93%

Diabetes: Concepts of β-Cell Organ Dysfunction and Failure Would Lead to Earlier Diagnoses and Prevention

Charles

Leslie

2021

Diabetes

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Prevention of Type 1 Diabetes

Harrison

Fourlanos

Every

et al. 2003

International Textbook of Diabetes Mellitus

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Increasing knowledge of the cellular and molecular mechanisms of autoimmune pancreatic β‐cell destruction, together with proof‐of‐principle for therapeutic interventions in the nonobese diabetic mouse model, provides a platform for the prevention of type 1 diabetes in humans. The concept of prevention extends to people with clinical diabetes, not only to preserve residual β‐cell function but to prevent recurrent autoimmune disease after therapeutic β‐cell replacement or regeneration. Primary prevention awaits the identification of environmental agents that trigger or promote disease on a background of genetic susceptibility. The last two decades have, however, witnessed clinical trials of a range of candidate agents for secondary prevention, predominantly in people with recently diagnosed diabetes. It can be argued that intervention is likely to be more effective in those at risk, identified by the presence of circulating islet antibodies. Strategies for secondary prevention encompass nonspecific immune suppression, nonspecific immune stimulation, nonspecific immune regulation, antigen‐specific immune regulation, and β‐cell protection. The shift has been away from nonspecific immunosuppressive drugs to more specific immunoregulatory agents. Preservation of C‐peptide secretion in the first year after diagnosis has been demonstrated in some randomized trials, but has not been sustained. Autoantigen‐induced immune regulation, which is safe and effective in animal models of autoimmune disease, requires further evaluation in at‐risk humans. The need for better surrogate immune and metabolic response markers, especially islet antigen‐reactive T‐cells, remains pressing. The prevention of type 1 diabetes will most likely occur incrementally, with increasingly specific and targeted agents being evaluated according to disease stage and risk, analogous to the evolving treatment regimens for cancer or HIV. This chapter describes the rationale and current approaches to the prevention of type 1 diabetes.

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Type 1 Diabetes Intervention Trials: What Have We Learned? A Critical Review of Selected Intervention Trials

Greenbaum

2002

Clinical Immunology

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The Use of Glipizide Combined with Intensive Insulin Treatment for the Induction of Remissions in New Onset Adult Type I Diabetes

Cited by 14 publications

References 29 publications

Diabetes: Concepts of β-Cell Organ Dysfunction and Failure Would Lead to Earlier Diagnoses and Prevention

Diabetes: Concepts of β-Cell Organ Dysfunction and Failure Would Lead to Earlier Diagnoses and Prevention

Prevention of Type 1 Diabetes

Type 1 Diabetes Intervention Trials: What Have We Learned? A Critical Review of Selected Intervention Trials

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