Immune-mediated diabetes is established as an autoimmune disease, which mos
t often is induced during late infancy or early childhood. Multiple genetic
lesions in immune tolerance are required before autoimmunity can be sustai
ned once induced by environmental agents, such as viruses. The diagnostic h
allmarks of the disease are the islet autoantibodies, which should be made
routinely available to physicians to distinguish this disease from other fo
rms of diabetes. The ability to identify individuals with impending IMD and
those at high risk of IMD lends itself to the development of clinical tria
ls to prevent diabetes by immunologic means. We believe that this will soon
be possible with the development and use of vaccines.(34)