Background: 11 patients were referred to our Molecular Genetics Department at the Royal Devon and Exeter\nHospital between 2000-2012 with a physician�s diagnosis of remitting diabetes. Our aim was to identify patients\nwith remitting diabetes whose clinical presentation is not explained by any known aetiology of diabetes.\nMethods: We obtained longitudinal clinical data on all 11 patients from the hospital records. All patients were\naged between 0.5 and 35 years at diagnosis. We applied clinical criteria derived from the literature to establish\n1) definite diabetes, 2) diabetes initially severe-requiring treatment with insulin, 3) remission of diabetes, and\n4) exclusion of known causes of remitting diabetes.\nResults: 10 out of 11 patients had an alternative explanation for their remission or a clear diagnosis was not\nidentified. We identified a single patient with idiopathic remitting diabetes using these criteria. The patient was a\nwhite Caucasian female diagnosed aged 15 with symptoms of diabetes, laboratory glucose of 21.2 mmol/L and\nHbA1c 134 mmol/mol. Her BMI was 23.6 kg/m2. She was treated with basal bolus insulin but discontinued two\nyears after diagnosis due to hypoglycaemia. 13 years post diagnosis, she had a normal oral glucose tolerance\ntest during pregnancy (fasting glucose 4.5 mmol/L, 2 hr glucose 4.8 mmol/L) and an HbA1c of 30 mmol/mol.\nThis patient does not appear to have Type 1 or Type 2 diabetes, and furthermore does not fit into current\nclassifications of diabetes.\nConclusions: Idiopathic remitting diabetes is rare but does exist. Strict clinical criteria are important to ensure\npatients have a robust clinical diagnosis. Identification of more patients with idiopathic remitting diabetes will\nenable further study of the clinical course of this syndrome. Applying these strict criteria will allow the identification\nof patients with remitting diabetes to assess its aetiology.
Loading....