ABSTRACT
Cyclosporine, a potent suppressor of T helper cell function that terminates lymphokine production, had been used in transplant recipients with convincing evidence of superiority over Azathioprine and Prednisone. In all of the studies, insulin-dependent diabetes mellitus was diagnosed in accordance with the criteria of the National Diabetes Study Group. The exquisite time requirement for early intervention measured in days or weeks is not consistent with the thesis that beta cell destruction occurs at a continuous and steady rate until there is total loss of insulin secretion. Whether maintenance of remission can occur in the longer term is a much more difficult and unanswered question, both with respect to effectiveness and safety. Occasional long-term remissions occur spontaneously, so that until patients are studied with a control group in a long duration protocol, the attribution of effects to cyclosporine remains unproven. It appears on clinical grounds that patients have intermittent and acute relapses, unassociated with obvious precipitating factors.
