Article ; Online: Low-Dose Antithymocyte Globulin: A Pragmatic Approach to Treating Stage 2 Type 1 Diabetes.
2023 Volume 47, Issue 2, Page(s) 285–289
Abstract: Objective: Low-dose antithymocyte globulin (ATG) (2.5 mg/kg) preserves C-peptide and reduces HbA1c in new-onset stage 3 type 1 diabetes, yet efficacy in delaying progression from stage 2 to stage 3 has not been evaluated.: Research design and methods!# ...
| Abstract | Objective: Low-dose antithymocyte globulin (ATG) (2.5 mg/kg) preserves C-peptide and reduces HbA1c in new-onset stage 3 type 1 diabetes, yet efficacy in delaying progression from stage 2 to stage 3 has not been evaluated. Research design and methods: Children (n = 6) aged 5-14 years with stage 2 type 1 diabetes received off-label, low-dose ATG. HbA1c, C-peptide, continuous glucose monitoring, insulin requirements, and side effects were followed for 18-48 months. Results: Three subjects (50%) remained diabetes free after 1.5, 3, and 4 years of follow-up, while three developed stage 3 within 1-2 months after therapy. Eighteen months posttreatment, even disease progressors demonstrated near-normal HbA1c (5.1% [32 mmol/mol], 5.6% [38 mmol/mol], and 5.3% [34 mmol/mol]), time in range (93%, 88%, and 98%), low insulin requirements (0.17, 0.18, and 0.34 units/kg/day), and robust C-peptide 90 min after mixed meal (1.3 ng/dL, 2.3 ng/dL, and 1.4 ng/dL). Conclusions: These observations support additional prospective studies evaluating ATG in stage 2 type 1 diabetes. |
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| MeSH term(s) | Child ; Humans ; Antilymphocyte Serum/therapeutic use ; Blood Glucose ; Blood Glucose Self-Monitoring ; C-Peptide ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/chemically induced ; Glycated Hemoglobin ; Hypoglycemic Agents ; Insulin ; Prospective Studies | ||||||||||
| Chemical Substances | Antilymphocyte Serum ; Blood Glucose ; C-Peptide ; Glycated Hemoglobin ; Hypoglycemic Agents ; Insulin | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2023-12-20 | ||||||||||
| Publishing country | United States | ||||||||||
| Document type | Journal Article | ||||||||||
| ZDB-ID | 441231-x | ||||||||||
| ISSN | 1935-5548 ; 0149-5992 | ||||||||||
| ISSN (online) | 1935-5548 | ||||||||||
| ISSN | 0149-5992 | ||||||||||
| DOI | 10.2337/dc23-1750 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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