ESPE Abstracts

Type 1 diabetes mellitus (T1DM) is a condition caused by the clonal generation of autoantibodies by B cells. Rituximab, an immunosuppressive agent, has been shown in studies to protect pancreatic function in individuals newly diagnosed with type 1 diabetes mellitus (T1DM). We investigated the effects of rituximab in two individuals with newly diagnosed T1DM. Case 1 was a 10-year-old boy, and Case 2 was a 4-year-old girl, both of whom had T1DM. Insulin secretion capability was still present, as there was a detectable c peptide level in both cases. Rituximab treatment prevented pancreatic cell destruction and preserved some endogenous insulin production. In Case 1, HbA1c levels showed a significant drop on the same drugs and then steadily increased until returning to pre-rituximab levels one year later. In Case 2, however, HbA1c remained below 6.5% for 8 months following therapy and was below 7% after the second Rituximab dose. Both patients were administered a second Rituximab dose one year after the first one. While the second case remained on the same medications for maintenance of HbA1c, the first case was able to be maintained on just long-acting insulin without the need for the short-acting as before. Both patients are under close monitoring for glycemic control, insulin secretion capability, and adverse effects.