Diagnosis of pre-type I diabetes

Relationship Between First-Phase Insulin Secretion and Age, HLA, Islet Cell Antibody Status, and Development of Type I Diabetes in 220 Juvenile First-Degree Relatives of Diabetic Patients

“…The three others showed a slow deterioration of their glucose tolerance, and their first-phase insulin response remained borderline for several years. These results are in agreement with studies showing that a low first-phase insulin response in ICA + subjects with a high-risk genetic background indicates that these subjects are very likely to develop type I diabetes within a few years, whereas a normal insulin response does not exclude a rapid progression to the disease (18,19).…”

Correlations of In Vivo β-Cell Function Tests With β-Cell Mass and Pancreatic Insulin Content in Streptozocin-Administered Baboons

“…McCULLOCH AND ASSOCIATES range of conditions from normality to extreme insulin deficiency. The in vivo measurements used in this study are virtually identical to those used in the prospective evaluation of humans at risk of developing IDDM (1,(12)(13)(14). Therefore, these measurements allow a direct comparison between the observed p-cell function and the p-cell mass associated with it.…”

“…Various islet .stimuli have been used in these tests, including intravenous glucose (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), arginine both at basal glucose level (2)(3)(4)(6)(7)(8)12,14) and during hyperglycemic clamp (2,3,7,8,12,14), tolbutamide (6,10,12,14), or glucagon (6). Some differentiation has been made between the insulin responses to various secretagogues during the development of IDDM, suggesting that the insulin responses to intravenous glucose are reduced earlier than the insulin responses to intravenous arginine (6,14) or oral glucose (6).…”

Scientific and ethical consequences of disease prediction

“…Its clinical manifestations develop only slowly -there is a long prodromal phase (which is probably longer in adults than in children) in which evidence of immune activation can be found [3,4]. Mild abnormalities of insulin secretion or glucose homeostasis or both can then be identified before symptomatic diabetes is demonstrable [5,6]. This slow development of clinical disease potentially admits several opportunities for intervention in the disease process to retard or arrest its progression.…”

“…In recent years the possession of certain gene alleles has been associated with high or low risk of developing diabetes [5]. It is important to realise that these genetic markers can only indicate a predisposition to Type 1 diabetes and do not constitute a presymptomatic diagnosis.…”