Speculations on etiology of diabetes mellitus. Tumbler hypothesis.
Although clinically useful, the conventional partition of diabetes mellitus into two major classes, insulin dependent and non-insulin dependent, has become obsolete from an etiological standpoint. Contemporary research, particularly that with advanced cellular and molecular methodologies, suggests that the expression of diabetes depends on a wide range of factors. We suggest that the etiology of diabetes has become analogous to the cylinder of a lock containing many tumblers. Each tumbler, e.g., environment, genetics, or cellular interactions, must be aligned before the key can be turned and an understanding of the etiologic process claimed.
Rossini
A A
AA
Department of Medicine, University of Massachusetts Medical School, Worcester 01605.
Mordes
J P
JP
Handler
E S
ES
D003920:Diabetes Mellitus / Q000145:classification / Q000209:etiology* / Q000235:genetics; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology; D004198:Disease Susceptibility; D004777:Environment; D006801:Humans; D008954:Models, Biological