Type 1 diabetes(T1D) is an autoimmune disease characterized by loss of insulin producing beta cells and reliance on exogenous insulin for survival.T1 D is one of the most common chronic diseases in childhood and the incidence is increasing,especially in children less than 5 years of age.In individuals with a genetic predisposition,an unidentified trigger initiates an abnormal immune response and the development of islet autoantibodiesdirected against proteins in insulin producing beta cells.There are currently four biochemical islet autoantibodies measured in the serum directed against insulin,glutamic decarboxylase,islet antigen 2,and zinc transporter 8.Development of islet autoantibodies occurs before clinical diagnosis of T1 D,making T1 D a predictable disease in an individual with 2 or more autoantibodies.Screening for islet autoantibodies is still predominantly done through research studies,but efforts are underway to screen the general population.The benefits of screening for islet autoantibodies include decreasing the incidence of diabetic ketoacidosis that can be life threatening,initiating insulin therapy sooner in the disease process,and evaluating safe and specific therapies in large randomized clinical intervention trials to delay or prevent progression to diabetes onset.
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