TYPE-1 DIABETES-MELLITUS - IS THIS HETEROGENEOUS AUTOIMMUNE-DISEASES PREDICTABLE, PREVENTABLE, CURABLE

Type 1 diabetes mellitus (DM) is generally believed to be a chronic au toimmune disease. Autoantibodies are detectable before and during clin ical onset of type I DM. Clinical presentation, biological markers, hi stopathologic lesions, and incidence all vary markedly with age at dia gnosis. It follows that use of national registries is essential to obt ain groups of representative patients. In 1989, the Belgian Diabetes R egistry started a study of incident DM cases and of their first-degree relatives younger than do years nf age. In this age group, over 90% o f patients with type 1 DM had at least one type of autoantibodies dire cted to beta-cell islet antigens. However, the nature of biological ma rkers present at clinical onset tended to vary with age. Detection of autoantibodies in first-degree relatives of patients allows to detect the disease at the preclinical stage and to evaluate relatively safe p reventive interventions in high-risk subjects. Several international s tudies in this area have been started, and others are being planned.