SARDINIA - A BATTLEFIELD APPROACH TO TYPE-I DIABETES EPIDEMIOLOGY

Sardinia and Finland have the highest incidence of insulin-dependent d iabetes mellitus (IDDM) in the world, Therefore, both regions represen t ideal observatories for investigating the environmental, genetic and immunological factors which have led to this dramatic increase, We ha ve concentrated our efforts on Sardinia, Among several projects, there is the mapping of the island for hot and cold spots for overt IDDM. I n order to map the island for pre-IDDM, we have collected and bled aro und 10,000 school children (age 6-14 years) and we are now in the proc ess of enrolling around 30,000 new-born babies, We report here our ini tial results, which show that progression to IDDM is accompanied in bo th cohorts by the presence of a combination of islet-cell antibodies w ith either glutamic acid decarboxylase or IA-2 antibodies or both, Thi s approach should lead to the design of reliable models of IDDM predic tion in the general population, which will benefit an early insulin tr eatment and, hopefully, an effective prevention of the disease.