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Molecular Manipulation of Autoantibody Testing in Type 1 Diabetes: Two for One

¹ Department of Pathology, Brigham and Women’s Hospital, and, Harvard Medical School, Boston, MA 02115

² Department of Medicine, University of Washington, Seattle, WA 98195

^aAddress correspondence to this author at: Brigham and Women’s Hospital, Thorn 530, 75 Francis St., Boston, MA 02115. Fax 617-278-6921; e-mail dsacks@rics.bwh.harvard.edu.

Diabetes mellitus is an epidemic that, according to estimates, will have a prevalence of 5.4% of the global population by the year 2025 (1). The number of adults with diabetes in the world is expected to rise from 135 million in 1995 to 300 million by 2025. Although the majority of the escalation will be attributable to type 2 diabetes, the prevalence of type 1 diabetes is also increasing. Data pooled from 27 countries reveal that the incidence of type 1 diabetes is rising by 3% per year (2), predominantly in children and young adults. In addition, several studies report that 10% of type 2 diabetes patients have islet autoantibody markers of type 1 diabetes, which predict insulin dependency (3)(4). Because the number of patients classified with type 2 diabetes is 10- to 20-fold greater than those deemed to have type 1 diabetes, this group of possible slow-onset type 1 diabetes is likely to have a significant impact on the severity of the diabetes epidemic.

Despite advances in diabetes treatment and monitoring that permit improved glycemic control, insulin therapy is inadequate to prevent patients from developing eye, kidney, nerve, and cardiovascular disease. Moreover, tight control, which cannot be achieved by all patients, is associated with a substantially increased risk of hypoglycemia (5). A desirable goal in the management of diabetes is to prevent the disease before clinical onset. Although several strategies aimed at prevention are under evaluation (6)(7), this will be attained only if type 1 diabetes can be diagnosed before the appearance of clinical . . . [Full Text of this Article]

References

The following articles in journals at HighWire Press have cited this article:

				W. E. Winter, N. Harris, and D. Schatz Immunological Markers in the Diagnosis and Prediction of Autoimmune Type 1a Diabetes Clin. Diabetes, October 1, 2002; 20(4): 183 - 191. [Abstract] [Full Text] [PDF]