ESPE Abstracts

Introduction and Objective: In patients with Type 1 Diabetes Mellitus (DM), a reduction in insulin requirement often occurs 2-4 weeks after diagnosis. Although the underlying mechanisms of this reduction in insulin requirement are not fully understood, the benefits it provides to the patient are significant. It is suggested that several factors may influence this period, known as the remission (honeymoon) phase. Our study aims to contribute to the literature by examining these factors that may affect the honeymoon phase.

Material and Method: Between November 2015 and November 2020, the clinical findings at admission, and the anthropometric and biochemical data (glucose, C-peptide, HbA1c) at admission and at the 3rd, 6th, 9th, and 12th months of patients newly diagnosed with Type 1 DM who regularly attended follow-up visits at a tertiary hospital's Pediatric Endocrinology Clinic were retrospectively reviewed from patient files. The insulin dose required at diagnosis and at the 3rd, 6th, 9th, and 12th months was recorded. The remission period was defined as having an insulin requirement of less than 0.5 IU/kg/day, an HbA1c level below 7%, and an IDAA1c (insulin dose-adjusted HbA1c) of less than 9. IDAA1c was calculated as HbA1c (%) + 4 × (insulin dose (IU/kg/day)).

Results: A total of 310 patients were included in the study. Of these patients, 50.3% (156) were male and 49.7% (154) were female. Among the 310 patients included in our study, 185 (60%) were diagnosed with diabetic ketoacidosis, 73 (23.5%) with diabetic ketosis, and 51 (16.5%) with hyperglycemia. The anthropometric measurements and laboratory data of the cases at admission are presented in Table 1. Of the 310 patients, 121 (39%) entered a partial remission period, of which 54 (44.6%) were male and 66 (54.5%) were female. It was observed that the frequency and duration of experiencing the honeymoon phase did not differ by gender or admission clinic.

Discussion: It is known that good metabolic control during the remission period is associated with better metabolic control and fewer complications in subsequent years. Additionally, the emergence of new treatment options affecting this period makes the identification of patients who will experience remission more important. Our study found that certain clinical findings and laboratory values at admission may influence whether a partial remission period is experienced and its duration. However, to draw more definitive conclusions, new studies involving larger patient populations are needed.