Fövényi J1*, Pánczél P2, Thaisz E1
1Diabetes Outpatient Department, Peterfy Sandor Hospital-Clinic and Manninger Jenő National Insitute for Traumatology, Budapest, Hungary
23rd Dept. of Internal Medicine, Semmelweis University, Budapest, Hungary
Corresponding Author: József Fövényi
Address: Diabetes Outpatient Dept., Peterfy Sandor Hospital-Clinic and Manninger Jenő National Insitute for Traumatology, H-1076 Budapest, Péterfy Sándor Street 8-20. Hungary; E-mail: firstname.lastname@example.org
Received date: 11 November 2019; Accepted date: 28 November 2019; Published date: 2 January 2020
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.
Citation: Fövényi J, Pánczél P, Thaisz E. Healthy Pregnancy and Birth during Unusually Long-Lasting Remission of Type-1 Diabetes: Case Report. Asp Biomed Clin Case Rep. 2020 Jan 2;3(1):1-5.
Copyright © 2020 Fövényi J, Pánczél P, Thaisz E. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Type-1 Diabetes; Long Term Remission; Pregnancy During Remission; Basisinsulin Treatment; Multiple Daily Insulin
Abbreviations: CGM: Continuous Glucose Monitoring; GADA: GAD Antibody; MDI: Multiple Daily (Insulin) Injection; OGTT: Oral Glucose Tolerance Test; TIDM: Type-1 Diabetes Mellitus