[Predicting insulin-dependent diabetes. Study of risk markers].
The presence of specific antibodies at the time of clinical diagnosis, together with genetic susceptibility and animal models of spontaneous diabetes obtained by immunological destruction of insulin-secreting cells, suggests that insulin-dependent (type I) diabetes is an autoimmune disease. Prospective studies conducted among first-degree relatives of type I diabetes patients or in the general population have identified 3 types of markers appearing during subclinical destruction of islet cells, or pre-diabetes, which can be used to detect subjects at high risk. These are: high-titer anti-islet antibodies (ICA), anti-insulin autoantibodies and early insulin response to intravenous hyperglycaemia. Owing to the great heterogeneity of metabolic profiles, immunological markers alone cannot predict the time when insulin-dependence will occur. The psychological impact of these studies is such that they should be carried out only in specialized centres. Identifying pre-diabetes is important for the prevention of the disease. Until immunomodulators devoid of side-effects are available, pre-diabetes is a good period to train the patients and start insulin therapy when it becomes necessary.
Thivolet
C
C
Clinique endocrinologique, Hôpital de l'Antiquaille, Lyon.
D001323:Autoantibodies / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D005819:Genetic Markers / Q000235:genetics; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology; D011379:Prognosis; D012307:Risk Factors
D001323:Autoantibodies; D005819:Genetic Markers
Prédiction du diabète insulinodépendant. Etude des marqueurs de risque.