We have defined and characterized the natural history of spontaneous near-normoglycemic remission off of antidiabetic medication in 79 black NIDDM subjects. They had initially presented with plasma glucose levels of 37.8 ± 19.3 mmol/l. Baseline clinical metabolic and 8-year prospective data were obtained (51 men and 28 women, mean age 45 ± 10 years, islet-cell or GAD antibody negative). After hospitalization and intensive outpatient treatment, near-normoglycemic remission (fasting plasma glucose 6.1 ± 0.83 mmol/l and HbA1c 0.95 ± 0.10 of upper limit of normal) occurred within 8 ± 10 months of insulin or sulfonylurea therapy. This was unrelated to the resolution of stress or significant weight loss (1.9 ± 4.97 kg). Metabolic studies performed during remission showed 17% normal, 33% impaired, and 50% diabetic glucose tolerance. Glucose disposal (1 mU · kg−1 · min−1) euglycemic insulin clamp with D-[3-3)H]glucose) was higher in the normal glucose tolerance group compared with the impaired and diabetic groups (37.8 ± 10.2 vs. 26.1 ± 10.7 and 26.7 ± 12.0 μmol · kg−1 · min−1; P < 0.05) despite similar BMIs in all three groups (28.8 ± 3.7 kg/m2). Insulin secretion was below the normal range. Of 79 patients, 27 relapsed. A Kaplan-Meier survival analysis gives a median time of 40 months to relapse. Higher presenting plasma glucose and male sex predicted earlier relapse. Near-normoglycemic remission may occur in up to 30% of black new-onset NIDDM patients. It appears to be associated with intensive initial glycemic regulation and may be a method of decreasing the development of microvascular complications in NIDDM.
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Original Articles| March 01 1996
Long-Term Normoglycemic Remission in Black Newly Diagnosed NIDDM Subjects
Mary Ann Banerji;
Rochelle L Chaiken;
Address correspondence and reprint requests to Dr. Mary Ann Banerji, SUNY Health Science Center at Brooklyn, 450 Clarkson Ave., Box 1205, Brooklyn, NY 11203.
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Mary Ann Banerji, Rochelle L Chaiken, Harold E Lebovitz; Long-Term Normoglycemic Remission in Black Newly Diagnosed NIDDM Subjects. Diabetes 1 March 1996; 45 (3): 337–341. https://doi.org/10.2337/diab.45.3.337
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