Type 1 diabetes mellitus

Positive diagnosis: Among the various diseases leading to chronic hyperglyc emia, type 1 diabetes mellitus is distinctive by the presence of specific a utoantibodies. The common form of type 1 diabetes mellitus is insulin-depen dant diabetes, but type 1 diabetes may also present as non-insulin-dependen t. In order to predict insulin-dependence and screen for associated autoimm une diseases, search for autoantibodies is required in all patients with di abetes, whatever the clinical presentation. Complex pathophysiology: Diabetes mellitus is a multifactorial disease impl icating of environmental and genetic factors leading to breakdown immune to lerance. Long preclinical phase: Chronic hyperglycemia is preceded by a long preclin ical phase during which the only observable anomalies result from activatio n of the immune system. With the development of simplified techniques for d etecting autoantibodies, it would be reasonable to foresee large-scale scre ening. Ongoing secondary prevention trials: The goal is to prevent the development of chronic hyperglycemia by intervening early, during the infraclinical ph ase, in patients with signs of immune activation. At the time of diagnosis: When diabetes is discovered, intensive insulin th erapy helps preserve residual insulin secretion and guarantees better long- term metabolic control.