Objective: Evaluation the clinical efficacy of autologous hematopoietie stem cell transplantation and traditional insulin therapy.
Methods: This is a casecontrol study. The subject investigated were diagnosed primary childhood type 1 diabetes in Beijing Childrens Hospital Endocrinology Centre, and there are 14 cases did the immune intervention combined with autologous hematopoietie stem cell transplantation in other hospital during the first 3 months of diagnosis, then came back to our hospital diabetes clinic due to poor glycemic control or reuse insulin again. The 14 cases were set to the case group. Using 1:2 matches, we select the 30 cases of newly diagnosed type 1 diabetes in the corresponding period in our hospital as the control group, and compare the effect of diabetes control between the case group and control group. We also observed the diabetes control levels of restoring traditional treatment and duration of 4.2±1.8 years time in case group.
Results: The average time they once again to our hospital were at the duration of 10.7±4.2 months of the 14 cases in case group. Of which 11 cases had never been deactivated insulin replacement therapy, three cases have been treated with insulin were deactivated for the 2, 3, and 11 months, both in the diagnosis of diabetes duration of 1 year. All children in case group did not occur diabetic ketoacidosis after transplantation. At the time of restoring traditional treatment and the average duration of 4.2 years, we compare the same period of diabetes outpatient data with the control group, found that HbA1c of the control group was significantly lower than the case group, with a statistically significant difference (P<0.01%), while there is no significant difference (P>0.05) of insulin dosage and serum C-peptide level between the two groups; compare the current diabetes outpatient data of the case group and the control group over the same period, we found that HbA1c of the control group is still lower than case group (P<0.01%), while no significant difference (P>0.05) in insulin dosage, serum C-peptide level between the two groups. Compare the insulin dosage before and after AHST treatment, no significant difference (P>0.05).
Conclusion: At present, AHST treatment cannot significantly improve the diabetes control on the recent and long-term. Conventional insulin therapy remains the preferred treatment for children with primary type 1 diabetes. Attaches great importance to the five carriages comprehensive treatment.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology