ABSTRACT
The clinical treatment of insulin-dependent diabetes mellitus (IDDM), or Type I diabetes, has undergone profound changes. The development of IDDM in the human is characterized by the presence of islet-cell antibodies and autoreactive T lymphocytes. Nephrotoxicity is certainly the most troublesome of cyclosporine side effects. An increase in creatininemia of more than 50% above basal value was observed in 47% of patients treated with cyclosporine, as opposed to 4% in those receiving placebo. The risk of chronic nephrotoxicity becomes minimal when maintaining cyclosporine trough levels around 300 ng/ml and decreasing cyclosporine dosage as soon as blood creatinine level increases by more than 30% over basal values. Cyclosporine was given to forty children with type I diabetes in strictly controlled conditions in order to ascertain a safe use of the drug. Immunological studies performed in cyclosporine treated diabetic patients have provided useful information in the putative mechanisms of remission induction and more generally on the effector mechanisms in type I diabetes.
