PREDICTION AND PREVENTION OF TYPE-1 DIABETES - WHAT CAN BE EXPECTED FROM GENETICS

Current prediabetes screening relies mainly on immunologic markers. Ge netic screening through HLA typing, which is used in families of affec ted patients, allows a stratification of risk levels according to the number and nature of alleles shared with the proband. Incomplete penet rance and the polygenic nature of susceptibility currently limit our a bility to predict the disease with genetic markers. In addition, genet ic factors can affect several aspects of the disease process, includin g insulin secretory capacity. This paper discusses the present and pot ential roles of genetic markers in prediabetes screening and briefly c onsiders their use in the context of prevention trials.