Two Patients With Extremely Long Type 1 Diabetes Duration With Very Few Complications and Remaining Insulin Secretion

Area of Science:

• Endocrinology
• Metabolic Diseases
• Clinical Research

Background:

• Type 1 Diabetes (T1D) is an autoimmune disease characterized by insulin deficiency.
• Long-term T1D management often involves significant microvascular and macrovascular complications.
• Patient resilience to T1D complications is not fully understood.

Purpose of the Study:

• To investigate the factors contributing to a benign clinical phenotype in two elderly patients with T1D.
• To identify potential resilience factors against angiopathy in long-standing T1D.
• To explore the implications of detectable C-peptide in T1D for novel treatment strategies.

Main Methods:

• Case report detailing the clinical history and risk factors of two T1D patients.
• Assessment of complication status, particularly angiopathy.
• Measurement of C-peptide levels to evaluate residual beta-cell function.

Main Results:

• Two patients over 80 years old with T1D presented with minimal complications.
• Both patients exhibited detectable C-peptide levels, indicating some residual pancreatic beta-cell function.
• Specific risk factors and protective elements contributing to their resilience were characterized.

Conclusions:

• The presence of detectable C-peptide may be associated with a milder T1D phenotype and reduced complications.
• Understanding the mechanisms of resilience in these patients could reveal novel therapeutic targets for T1D.
• Further research into protective factors is warranted to improve long-term T1D outcomes.