The factors relevant to partial remission in children with type 1 diabetes mellitus after measles vaccination: A retrospective study

• Published in: Journal of medical virology 2020-12, Vol.92 (12), p.2955-2960
• Main Authors: Bektaş, Gonca, Önal, Hasan, Adal, Erdal
• Format: Article
• Language: English
• Subjects: Adolescent; C-Peptide - blood; Child; Child, Preschool; Children; Confidence intervals; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetic ketoacidosis; Diagnosis; Dosage; Female; Glycated Hemoglobin - analysis; Hemoglobin; Humans; immune system; Immunization; Immunomodulation; Infant; Insulin; Ketoacidosis; Letters to the editor; Male; Measles; Measles - prevention & control; Measles Vaccine - administration & dosage; measles virus; Noncompliance; Peptides; Remission; Remission (Medicine); Remission Induction; Retrospective Studies; Treatment Outcome; Vaccination; Virology
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.25734

We aimed to identify the determinants of partial remission in patients with type 1 diabetes mellitus (DM), and whether there is an influence of vaccination against measles on partial remission. This was a retrospective study consisting of consecutive patients diagnosed with type 1 DM followed‐up from 1 September 2010, through 30 November 2011. The study included children vaccinated within 3 months after diagnosis, and children unvaccinated during the first 12 months of the disease. The daily insulin dose, hemoglobin A1c, and C‐peptide levels, and whether children are in partial remission based on the insulin dose‐adjusted HbA1c were recorded at diagnosis and 3, 6, 9, 12, 24, and 36 months. A total of 55 children with type 1 DM were analyzed. Thirty‐one patients (56.4%) reached partial remission during the follow‐up period, whereas 24 of them did not. Patients with diabetic ketoacidosis (DKA) at diagnosis were less likely to reach partial remission than patients without DKA (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.062‐0.946; P = .038). Patients vaccinated against measles were more likely to be in partial remission than patients unvaccinated (OR, 4.2; 95% CI, 1.35‐13; P = .011). Partial remission was significantly associated with the C‐peptide level and insulin dosage at diagnosis P = .002; P = .013, respectively). The lack of DKA, higher C‐peptide level, and lower insulin dosage at diagnosis, and vaccination against measles after diagnosis may have an influence on partial clinical remission in patients with new‐onset type 1 DM. Highlights More than half of the patients with type 1 diabetes mellitus may reach partial remission. The lack of diabetic ketoacidosis, higher C‐peptide level, and lower insulin dosage may be related to partial remission. Vaccination against measles may influence the partial remission by immunomodulation.