Genetic studies of immunological markers in diabetes: prediction of insulin dependence

ABSTRACT

The classification based on the physiopathological criteria distinguishes type I diabetes, observed in patients with stigmata of anti-islet of Langerhans autoimmunity, from type II diabetes without these autoimmune changes. Type I diabetes is subdivided into classes la and Ib, class Ib comprising those cases associated with other autoimmune diseases. Yet, in the present work, serological analysis of 76 patients with clinical type la diabetes and 215 healthy, first degree relatives was not clear cut and revealed that at least some patients that are classified clinically as la were in fact intra-clinical Ib subjects. Forty one percent of patients with class la diabetes had anti-gastric, anti-adrenal or anti-thyroid antibodies, and 28% of their healthy relatives also had the same types of antibodies, several prospective studies of the families of patients with type I diabetes have shown that anti-islet of Langerhans antibodies were associated with a high risk of diabetes. similarly, the presence of these antibodies in patients apparently with Type II diabetes [266 NIDD patients] has been associated with an increased risk of developing insulin dependence. These results illustrate the value of immunological investigation in diabetic patients; as this may influence the choice of treatment in the future