Healthy Pregnancy and Birth during Unusually Long-Lasting Remission of Type-1 Diabetes: Case Report

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Healthy Pregnancy and Birth during Unusually Long-Lasting Remission of Type-1 Diabetes: Case Report

Authors
  • Fövényi J1
  • Pánczél P2
Type
Published Article
Journal
Asploro Journal of Biomedical and Clinical Case Reports
Publisher
Asploro Open Access Publications
Publication Date
Jan 21, 2020
Accepted Date
Nov 21, 2019
Volume
3
Issue
1
Pages
1–5
Identifiers
DOI: 10.36502/2019/asjbccr.6175
Source
MyScienceWork
Keywords
License
Green

Abstract

The 26-year-old woman was diagnosed with type 1 diabetes in 2014. The diagnosis was confirmed while there was a slight increase in blood glucose and HbA1c levels using oral glucose tolerance test, determination of insulin levels and GADA testing. This was followed by a 2-year period with complete remissions and partial remissions of 2-8 U daily basal insulin glargine. Thereafter, the patient became pregnant. The minimal basal insulin used to date has been switched to human rapid-acting and NPH insulins five times daily, which had to be increased to 11 times the initial dose in the third trimester of pregnancy. After a successful spontaneous birth of a healthy baby girl, our patient wished to return to one-tenth of the maximum insulin dose that was used during pregnancy, to once daily insulin glargine. After three months, her blood glucose levels began to rise, with oral glucose challenge test showing a marked increase in blood glucose and a drastic reduction in C-peptide levels. This was when we switched to multiple daily insulin administration using glargine basal- and glulisine analogue insulins. Later, glargine was switched to insulin degludec, and with a 30-33 U total daily insulin dose and CGM for the past two years, the patient was in a satisfactory metabolic state.

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