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Long-lasting remission of type 1 diabetes following treatment with topiramate for generalized seizures

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Abstract

We report a case of unusually long-lasting remission of type 1 diabetes (T1D). The patient, a Caucasian man, at the age of 43 years developed a ketotic diabetes, classified as type 1 based on clinical presentation and positivity for islet autoantibodies. Shortly after diabetes onset, oral topiramate was added to preexisting valproic acid for generalized seizures and maintained thereafter. Initial intensive insulin treatment was rapidly reduced to low doses (3 Units/day) maintained for a long time and then discontinued at month 55; fasting glucose and glycosylated hemoglobin were basically normalized at 58 months. An oral glucose tolerance test performed at month 53 showed an impaired fasting glucose (6.0 mmol/l) and a value slightly above the threshold for the diagnosis of diabetes at 2 h (11.2 mmol/l). We hypothesize that this unusually prolonged preservation of β-cell function might be ascribed to the concomitant therapy with topiramate, an antiepileptic agent with demonstrated efficacy as antidiabetic in type 2 diabetes (T2D). Topiramate should be further investigated as candidate agent for the preservation of β-cell function also in T1D.

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Acknowledgments

We thank L. Adorini for the critical review of the manuscript and advice.

Conflict of interest

All the Authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported. This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Department of Internal Medicine, Diabetes and Endocrinology Unit, San Raffaele Scientific Institute, and Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Alberto M. Davalli & Emanuele Bosi

  2. Department of Molecular Science, Università degli Studi di Milano, 20132, Milan, Italy

    Carla Perego

  3. Department of Medicine Diabetes Division, University of Texas Health Science Center, San Antonio, TX, 78229, USA

    Franco B. Folli

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  1. Alberto M. Davalli
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  2. Carla Perego
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  3. Franco B. Folli
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  4. Emanuele Bosi
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Correspondence to Alberto M. Davalli.

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Davalli, A.M., Perego, C., Folli, F.B. et al. Long-lasting remission of type 1 diabetes following treatment with topiramate for generalized seizures. Acta Diabetol 49, 75–79 (2012). https://doi.org/10.1007/s00592-011-0268-y

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