PREDNISONE ADMINISTRATION IN RECENT ONSET TYPE-I DIABETES

The aim of our study was to investigate the efficacy of prednisone to preserve pancreatic β-cell function in patients with recent-onset Type I diabetes mellitus (IDDM). Twenty-five patients with IDDM, aged 24±6 years, entered the trial within 8 weeks of the onset of diabetes. They were allocated, according to a single blind randomized protocol, to one of the following treatments: (A) prednisone (15 mg/day), (B) indomethacin (100 mg/day), (C) placebo. All treatments lasted 8 months and all patients achieved satisfactory metabolic control with a multi-injection regimen (three injections/day) within a few weeks, and maintained it throughout the entire period of observation. Only minor side effects were observed in the prednisone-treated patients. A lower insulin requirement was observed in the prednisone group than in other patients at 12 months (0·33±0·11 vs 0·57±0·06 U/kg/day, P<0·05), 18 months (0·34±0·11 vs 0·64±0·06, P<0·05) and 24 months (0·38±0·10 vs 0·63±0·05, P<0·05). Endogenous insulin release, evaluated as urinary C-peptide, was higher in the prednisone group than in other patients at 3, 6, 9, 12, 18and 24 months (P<0·05). ANOVA confirmed differences among the three groups. Our study indicates that prednisone administration, at low doses and for a long period of time, effectively restored endogenous insulin release in IDDM patients. © 1990 Academic Press Limited.