title: The convergence of type 1 and type 2 diabetes in childhood: the accelerator hypothesis.
abstract: It seems likely that type 1 and type 2 diabetes lie at different points of the same spectrum, separated by the misunderstanding that one belongs to childhood and the other to adulthood. The spectrum is that of tempo--the rate at which beta cell function is lost over time. A combination of beta cell up-regulation (insulin demand, largely determined by obesity) and the genetically-determined immune response to it ('autoimmunity') determines tempo, ranging from slow to fast with every variant in between. There is good evidence that people who go on to develop type 1 (fast) diabetes are, like those who develop type 2 (slow diabetes), insulin resistant, and overwhelming evidence that body mass plays a key role. The prevention of type 1 diabetes may lie in weight restriction from an early age.
authors: University Medicine, Level 7, Derriford Hospital, Plymouth, UK. T.Wilkin@pms.ac.uk
authors: T J
authors: TJ
authors: Wilkin
mesh_terms: D000328:Adult; D017209:Apoptosis; D015551:Autoimmunity / Q000276:immunology; D015992:Body Mass Index; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology / Q000503:physiopathology*; D020022:Genetic Predisposition to Disease; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007333:Insulin Resistance / Q000235:genetics; D050417:Insulin-Secreting Cells / Q000276:immunology / Q000473:pathology / Q000502:physiology; D008954:Models, Biological; D009765:Obesity / Q000150:complications / Q000503:physiopathology
chemical_list: D007328:Insulin