Clinical trials of cyclosporin in IDDM.

Abstract:

:The results of uncontrolled trials in immunomodulation of insulin-dependent diabetes mellitus (IDDM) led to randomized controlled trials in Canada and Europe. In the Canadian open study, the rate of clinical remissions (target control of glycemia maintained with less than or equal to 0.15 U.kg-1.day-1 insulin) was unexpectedly high among 81 subjects who had been treated with cyclosporin for at least 3 mo (mean serum trough levels approximately 125 ng/ml by radioimmunoassay). Subjects entered the study within 14 wk of onset of symptoms and received 6 wk of insulin therapy. The clinical remission rate at 1 yr was 46%; of these patients, 84% were not receiving insulin. An effect on beta-cell function was suggested by recovery of plasma glucagon-stimulated C-peptide levels into the normal range in many patients, with maintenance of levels through 1 yr in patients in remission. On the basis of these findings, the French and Canadian-European study groups conducted randomized double-blind controlled trials of cyclosporin, which confirmed the results of the open studies in terms of clinical remission. The Canadian-European study also demonstrated enhancement of beta-cell function by cyclosporin by 3 mo, which was maintained for 1 yr. In the Canadian open study, most patients relapsed within a few weeks after discontinuation of cyclosporin, indicating the need for longer-term immunomodulatory therapy for maintenance of remission. The nature and degree of structural change in kidney biopsies from patients in these studies are under assessment. The results strongly support the hypothesis that autoimmune mechanisms mediate beta-cell damage in many patients with IDDM.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Dupré J,Stiller CR,Gent M,Donner A,von Graffenried B,Heinrichs D,Jenner M,Keown P,Mahon J,Martell R

subject

Has Abstract,Author List Incomplete

pub_date

1988-11-01 00:00:00

pages

37-44

eissn

0149-5992

issn

1935-5548

journal_volume

11 Suppl 1

pub_type

临床试验,杂志文章
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  • Circulating levels of adipocyte and epidermal fatty acid-binding proteins in relation to nephropathy staging and macrovascular complications in type 2 diabetic patients.

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  • Does knowing one's elevated glycemic status make a difference in macronutrient intake?

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    doi:10.2337/dc14-1342

    authors: Bardenheier BH,Cogswell ME,Gregg EW,Williams DE,Zhang Z,Geiss LS

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  • Bimodal distribution of glucose is not universally useful for diagnosing diabetes.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-0867

    authors: Vistisen D,Colagiuri S,Borch-Johnsen K,DETECT-2 Collaboration.

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  • Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-2675

    authors: Neugebauer R,Fireman B,Roy JA,O'Connor PJ

    更新日期:2013-11-01 00:00:00

  • Novel use and utility of integrated electronic health records to assess rates of prediabetes recognition and treatment: brief report from an integrated electronic health records pilot study.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-1223

    authors: Schmittdiel JA,Adams SR,Segal J,Griffin MR,Roumie CL,Ohnsorg K,Grant RW,O'Connor PJ

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  • Microalbuminuria. Invalidity of simple concentration-based screening tests for early nephropathy due to urinary volumes of diabetic patients.

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    pub_type: 杂志文章

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-1711

    authors: Schnell O,Amann-Zalan I,Jelsovsky Z,Moritz A,Bermejo JL,Parkin CG,Schweitzer MA,Fisher L,Polonsky WH

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    pub_type: 杂志文章

    doi:10.2337/diacare.15.1.35

    authors: Larsen JL,Stratta RJ,Ozaki CF,Taylor RJ,Miller SA,Duckworth WC

    更新日期:1992-01-01 00:00:00

  • Quantitative importance of dietary constituents other than glucose as insulin secretagogues in type II diabetes.

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    pub_type: 杂志文章

    doi:10.2337/diacare.11.1.72

    authors: Nuttall FQ,Gannon MC

    更新日期:1988-01-01 00:00:00

  • Higher levels of urinary albumin excretion within the normal range predict faster decline in glomerular filtration rate in diabetic patients.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-2151

    authors: Babazono T,Nyumura I,Toya K,Hayashi T,Ohta M,Suzuki K,Kiuchi Y,Iwamoto Y

    更新日期:2009-08-01 00:00:00

  • Development and validation of a questionnaire to assess carbohydrate and insulin-dosing knowledge in youth with type 1 diabetes.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-0390

    authors: Koontz MB,Cuttler L,Palmert MR,O'Riordan M,Borawski EA,McConnell J,Kern EO

    更新日期:2010-03-01 00:00:00

  • Effects of peer-group intervention on metabolic control of adolescents with IDDM. Randomized outpatient study.

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    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.12.3.179

    authors: Anderson BJ,Wolf FM,Burkhart MT,Cornell RG,Bacon GE

    更新日期:1989-03-01 00:00:00

  • Increased plasma levels of endothelin 1 and von Willebrand factor in patients with type 2 diabetes and dyslipidemia.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.23.9.1395

    authors: Seligman BG,Biolo A,Polanczyk CA,Gross JL,Clausell N

    更新日期:2000-09-01 00:00:00

  • Association of Weight Loss Maintenance and Weight Regain on 4-Year Changes in CVD Risk Factors: the Action for Health in Diabetes (Look AHEAD) Clinical Trial.

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    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc16-0509

    authors: Wing RR,Espeland MA,Clark JM,Hazuda HP,Knowler WC,Pownall HJ,Unick J,Wadden T,Wagenknecht L,Action for Health in Diabetes (Look AHEAD) Study Group.

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  • Diabetes mellitus and cerebrovascular disease: prevalence of carotid artery occlusive disease and associated risk factors in 482 adult diabetic patients.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.6.3.274

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  • Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc20-0304

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  • Risk factors for myocardial infarction case fatality and stroke case fatality in type 2 diabetes: UKPDS 66.

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    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/diacare.27.1.201

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  • Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study.

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    pub_type: 杂志文章

    doi:10.2337/dc20-1712

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    pub_type: 杂志文章

    doi:10.2337/dc13-0194

    authors: Graveling AJ,Deary IJ,Frier BM

    更新日期:2013-10-01 00:00:00

  • Effects of dapagliflozin, an SGLT2 inhibitor, on HbA(1c), body weight, and hypoglycemia risk in patients with type 2 diabetes inadequately controlled on pioglitazone monotherapy.

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    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验

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    pub_type: 杂志文章

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  • Cross-sectional analysis of renal function in black Americans with NIDDM.

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    pub_type: 杂志文章

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    更新日期:1990-11-01 00:00:00

  • High systolic blood pressure increases prevalence and severity of retinopathy in NIDDM patients.

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    pub_type: 临床试验,杂志文章

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