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Partial Clinical Remission Reduces Lipid-Based Cardiovascular Risk in Adult Patients with Type 1 Diabetes

Date Posted: Wednesday, November 24, 2021

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A newly published study by UMass Chan Medical School physician-scientist Benjamin Udoka Nwosu, MD and his team showed that partial clinical remission of adults diagnosed with type 1 diabetes (T1D), commonly known as the honeymoon period, may reduce long-term cardiovascular risk.

Atherosclerotic cardiovascular disease (ASCVD) is a type of cardiovascular disease caused by high levels of bad cholesterol (LDL) in the blood.  It leads to the buildup of plaque on artery walls, which over time can lead to heart attack or stroke.  Risk factors for ASCVD are well established in type 2 diabetes (T2D), but not in T1D.

Patients who experience a honeymoon period can still produce some of their own insulin, and their blood glucose levels can be restored to at or near normal levels, for three months to a year after treatment begins.

“If you’re going to investigate lipid changes in adults, you must include the honeymoon phase in that equation,” said Dr. Nwosu, professor of pediatrics at UMass Chan Medical School and pediatric endocrinologist at UMass Memorial Health.  “People who did not experience a honeymoon phase expressed worse lipid profiles compared to those who did experience partial remission after they were diagnosed with diabetes.”  

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Benjamin Nwosu, MD  -  Sadichchha Parajuli, MD  -  Gabrielle Jasmin, Clinical Research Assistant

He believes that type 1 diabetes should be broken down into two separate entities, those who had a honeymoon phase (remitters) and those who did not (non-remitters).  “The outcome is very different,” he said.  “Honeymooners go on to have less complications from diabetes than the non-remitters."

In this study, non-remitters demonstrated a similar lipid phenotype to people with type 2 diabetes, while remitters expressed a favorable lipid profile similar to the control group who did not have diabetes.  This finding in adults is consistent with earlier reports in children and adolescents and supports the hypothesis that partial clinical remission may reduce long-term cardiovascular risk in people with T1D.

“We found the honeymoon period to be associated with a favorable early lipid phenotype that could translate to reduced long-term cardiovascular disease risk in adults,” added Dr. Nwosu. “It’s important for non-remitters to understand their increased risk and that they need to work that much harder to stay healthy.”

View their full publication titled Partial Clinical Remission Reduces Lipid-Based Cardiovascular Risk in Adult Patients With Type 1 Diabetes.

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