Triad of markers for identifying children at high risk of developing insulin-dependent diabetes mellitus
F. Ginsberg-Fellner, M. E. Witt, B. H. Franklin, S. Yagihashi, Y. Toguchi, M. J. Dobersen, P. Rubinstein and A. L. Notkins
A longitudinal investigation was conducted from 1977 to 1984 on 178
families in which one or more of the children had insulin-dependent
diabetes mellitus. Of 351 nondiabetic sibs followed up for an average of 54
months, ten have, thus far, become diabetic. Eight sibs were HLA identical
to their diabetic proband and nine had HLA-DR3 and/or HLA-DR4. Islet cell
surface antibody and islet cell cytoplasmic antibody were found from two to
74 months before the onset of clinical diabetes in 100% and 90%,
respectively, of the children. A decrease in insulin secretion was observed
in all of these children on entry into the study and was detected in the
absence of elevated plasma glucose concentrations. The data suggest that
the triad of HLA identity, pancreatic islet cell antibodies, and depressed
insulin secretion identifies those sibs who are at high risk of developing
insulin-dependent diabetes mellitus.
