# Two Patients With Extremely Long Type 1 Diabetes Duration With Very Few Complications and Remaining Insulin Secretion **Authors:** Åke Sjöholm, Daniel Espes PMC · DOI: 10.1002/ccr3.72183 · Clinical Case Reports · 2026-02-28 ## TL;DR Two elderly type 1 diabetes patients have minimal complications and retained insulin production, suggesting potential new treatment approaches. ## Contribution Identification of unique resilience factors in long-term type 1 diabetes patients with preserved insulin secretion. ## Key findings - Two patients over 80 years old with type 1 diabetes have very few complications. - Both patients retain detectable C-peptide, indicating some insulin secretion remains. - Their resilience against angiopathy may reveal new therapeutic targets. ## Abstract We present two patients with > 80 years with type 1 diabetes (T1D), but with minor complications. Their history and risk factors are characterized as are factors conferring resilience against angiopathy. Amazingly, both had clearly detectable C‐peptide. The underlying reasons for their benign phenotype could form the basis for novel treatment targets. ## Linked entities - **Diseases:** type 1 diabetes (MONDO:0005147) ## Full-text entities - **Genes:** HLA-DQA1 (major histocompatibility complex, class II, DQ alpha 1) [NCBI Gene 3117] {aka CELIAC1, DQ-A1, DQA1, HLA-DQA, HLA-DQA1*}, GAD2 (glutamate decarboxylase 2) [NCBI Gene 2572] {aka GAD65}, PTPRN (protein tyrosine phosphatase receptor type N) [NCBI Gene 5798] {aka IA-2, IA-2/PTP, IA2, ICA512, R-PTP-N}, HLA-DRB1 (major histocompatibility complex, class II, DR beta 1) [NCBI Gene 3123] {aka DRB1, HLA-DR1B, HLA-DRB, SS1}, HLA-DQB1 (major histocompatibility complex, class II, DQ beta 1) [NCBI Gene 3119] {aka CELIAC1, HLA-DQB, IDDM1}, HLA-A (major histocompatibility complex, class I, A) [NCBI Gene 3105] {aka HLAA}, INS (insulin) [NCBI Gene 280829], HLA-DRB4 (major histocompatibility complex, class II, DR beta 4) [NCBI Gene 3126] {aka DR4, DRB4, HLA-DR4B, HLA-DRB, HLA-DRB4*}, TNFRSF25 (TNF receptor superfamily member 25) [NCBI Gene 8718] {aka APO-3, DDR3, DR3, LARD, TNFRSF12, TR3}, SLC30A8 (solute carrier family 30 member 8) [NCBI Gene 169026] {aka ZNT8, ZnT-8}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10} - **Diseases:** vascular complications (MESH:D003925), T1D (MESH:D003922), diabetic ketoacidosis (MESH:D016883), aortic valve stenosis (MESH:D001024), abdominal obesity (MESH:D056128), hypoglycemic (MESH:C000721848), dyslipidemia (MESH:D050171), early death (MESH:D003643), hypertension (MESH:D006973), albuminuria (MESH:D000419), prostatic cancer (MESH:D011471), angiopathy (MESH:D001018), weight loss (MESH:D015431), polydipsia (MESH:D059606), polyuria (MESH:D011141), insulin deficiency (MESH:D007333), vasculopathy (MESH:D000090122), hypoglycemia (MESH:D007003), loss of consciousness (MESH:D014474), angiopathic (MESH:D011504), non-proliferative diabetic retinopathy (OMIM:603933), diabetic retinopathy (MESH:D003930), Diabetes (MESH:D003920) - **Chemicals:** lipid (MESH:D008055), glucose (MESH:D005947), C-peptide (MESH:D002096), creatinine (MESH:D003404), blood glucose (MESH:D001786), metoprolol (MESH:D008790), enalapril (MESH:D004656), amlodipine (MESH:D017311), alcohol (MESH:D000438), simvastatin (MESH:D019821), atorvastatin (MESH:D000069059), chlorpropamide (MESH:D002747), zinc- (MESH:D015032), glycated (-), triglycerides (MESH:D014280) - **Species:** Bos taurus (bovine, species) [taxon 9913], Nicotiana tabacum (American tobacco, species) [taxon 4097], Homo sapiens (human, species) [taxon 9606] ## Full text _Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12949425/full.md ## References 18 references — full list in the complete paper: https://tomesphere.com/paper/PMC12949425/full.md --- Source: https://tomesphere.com/paper/PMC12949425