Using an indirect immunofluorescence test on suspensions of viable, insulin-producing islet cells from rats, we found that 32 per cent (28/88) of insulin-treated patients with juvenile diabetes have islet-cell-surface antibodies in their circulation. These antibodies also occurred in four of nine children with glucose intolerance, in one of 24 healthy children and in nondiabetic children with thyroid disorders. In the diabetic children, the immunofluorescent reaction was inhibited by preadsorption of serum to islet cells but was little affected by preadsorption to rat hepatocytes or erythrocytes or to acetone powders of various rat tissues, including pancreas. These results show that organ-specific, nonspecies-specific antibodies reactive with the cell surface of the islet cells can be present in serum from diabetic children, and provide an approach to investigation of immunopathological aspects of diabetes mellitus.

Previous studies have shown a variety of immunological abnormalities in Type 1 (insulin-dependent) diabetes, including disturbances in peripheral lymphocytes and anti-lymphocyte antibodies. We measured subsets of T and natural killer cells with monoclonal antibodies in patients with diabetes, and also assayed for anti-lymphocyte antibodies using dual colour immunofluorescence and flow cytometry. We found a significant decrease in numbers of Leu 3a (helper/inducer) cells in Type 1 diabetic patients of recent onset and intermediate levels in patients with longer duration of the disease. Leu 4 (pan T cell) levels were reduced in Type 1 diabetic patients of more than 4 months duration. Leu 7 (natural killer cells) were increased in Type 2 (non-insulin-dependent) diabetic patients. Individual Type 1 diabetic patients of recent onset showed low levels of Leu 7 and 11 a (natural killer cell) levels with normal 3a levels. Autoantibodies against Leu 3a + cells were present in higher titres in the Type 1 diabetic patients of recent onset than in control subjects. We conclude: (1) Leu 3a cells may be decreased in Type 1 diabetic patients of recent onset and return to normal with time; (2) low numbers of Leu 7 and 11a cells with normal numbers of Leu 3a may be seen in some Type 1 diabetic patients of recent onset, which may help explain previous reports of decreased suppressor cells; (3) Leu 7 levels may be increased in Type 2 diabetes; (4) autoantibodies against Leu 3a + peripheral lymphocytes may be seen in Type 1 diabetic patients of recent onset. These appear to be a marker of autoimmune phenomena rather than immunological mediators.

No abstract

This study examined the psychological adjustment of children with diabetes and their siblings. Data were collected for 41 diabetic children and their siblings between ages 6 and 11 yr who were followed in a large pediatric practice. The diabetic group was matched with 35 control children who were followed for routine pediatric care and their siblings. Diabetic families and the controls did not differ on divorce rate or level of marital adjustment. Behavior problems were measured through the use of the Achenbach Behavior Checklist for both sexes separately at the 6-11- and 12-16-yr-old age levels. Diabetic boys, aged 6-11 yr, were higher than nondiabetic boys on internalizing and externalizing symptom scales, particularly on measures of schizoid tendencies, obsessive compulsive symptoms, hyperactivity, and aggression. Neither female patients, male siblings, nor female siblings in the 6-11-yr-old age group differed from controls on emotional adjustment. Among the 12-16-yr-old males, diabetic patients were higher on internalizing symptoms than male siblings and their controls. Male siblings tended to be lower than diabetic patients and controls on school performance. Social class differences may have contributed to the differences at the 12-16-yr age levels. Female subjects in the 12-16-yr-old group did not differ on measures of adjustment. Level of control was unrelated to patients' or siblings' adjustment, but behavioral symptoms tended to increase for male diabetic patients with length of illness, and tended to decrease for male siblings. Results are interpreted according to social class effects and sex differences.