New Directions in the Immunology of Autoimmune Diabetes

Excerpt

Although it has been recognized for several years that insulin-dependent diabetes mellitus is a chronic autoimmune disease (1), it has only recently been possible to identify antigens involved in the disease and to study possible precipitating events, the genetic determinants underlying the disorder, and its pathogenesis. Studies of concordant twins and triplets have shown evidence of autoimmunity toward islet cells as early as 7 to 10 years before the clinical presentation of the disease, even when oral glucose tolerance was normal (2). Other data have confirmed the appearance of autoantibodies before clinical presentation (3), and, on the basis of these