PARTIAL CLINICAL REMISSION IN TYPE 1 DIABETES: PANCREATIC Β - CELL FUNCTIONAL RESERVE, PRE-DICTORS, AND CLINICAL SIGNIFICANCE (A NARRA-TIVE REVIEW)

Abstract

Introduction. Partial clinical remission (the “honeymoon” phase) in type 1 diabetes (T1D) is characterized by transient recovery of pancreatic β-cell function and a temporary reduction in exogenous insulin requirements following the alleviation of glucotoxicity.

Aim. To synthesize current scientific evidence regarding the clinical significance, diagnostic criteria, and predictive factors of partial clinical remission in T1D.

Materials and methods. A narrative review of cohort studies, systematic reviews, and consensus guidelines on patients with newly diagnosed T1D was conducted using the PubMed and Google Scholar databases.

Results. The literature review indicates that the incidence of partial clinical remission ranges from 35% to 70%, with a typical duration of 3-12 months. Across the evaluated sources, the IDAA1c index (≤9) is highlighted as the current standardized surrogate marker of preserved stimulated C-peptide secretion (>300 pmol/L). Analysis of published data indicates that older age at T1D onset, absence of severe diabetic ketoacidosis (DKA), and higher baseline C-peptide levels are favorable predictors of partial remission. Preserved residual β-cell function facilitates glycemic control and may reduce the risk of severe hypoglycemia.

Conclusions. The remission phase represents an important therapeutic window in the clinical course of T1D. Intensive insulin therapy helps optimize glycemic control while reducing metabolic stress on residual β-cells, whereas disease-modifying immunotherapies aimed at preserving or prolonging remission remain under active clinical investigation.