The use of immunological markers in IDDM after more than 20 years from ICA description.

The use of immunological markers in IDDM after more than 20 years from ICA description.

The use of immunological markers in IDDM after more than 20 years from ICA description.

INTRODUCTION

Insulin-dependent diabetes mellitus (IDDM) is a disease caused by the autoimmune destruction of insulin-producing pancreatic p- cells which takes place in genetically predis- posed individuals.’P2 In recent years, thanks to the rapid advances in the knowledge on the p-cell destruction process, type 1 diabetes has become one of the best-characterized human
autoimmune disorders.
Once considered a disease of acute onset, it has clearly been established that in IDDM a preclinical prodromal phase that can last for years precedesthe clinical onset of the disease and that it is characterized by a series of immune (e.g., circulating autoantibodies and autoreactive T lymphocytes) and metabolic abnormalities (e.g., impaired insulin response during an intravenous glucose tolerance test (IVGTT).3,4 The determination of such immune and metabolic abnormalities in categories of
individuals at increased diabetes risk (e.g., first- degree relatives of type 1 diabetic subjects, women with gestational diabetes) allows diag- nosis already in the prodromal phase during which @-cells are being destroyed and at a time point of the pathogenetic process when a preventive attempt may still be successful.

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