Immunopathogenesis of Type 1 Diabetes in Western Society

Abstract

The classical type 1A diabetes or insulin‐dependent diabetes mellitus is a chronic immune‐mediated disease that leads to selective loss of insulin‐secreting β‐cells in the pancreas. This results in a series of complex metabolic aberrations that produce micro‐ and macrovascular complications, increasing morbidity and mortality. Despite decades of intense study of both humans and animal models (the biobreeding rat and nonobese diabetic mouse) to characterize the pathogenesis of type 1 diabetes, there is at present no demonstrated safe and effective preventive therapy. There has been a dramatic increase in the biochemical identification of islet autoantigens and in the definition of alleles of genes associated with diabetes susceptibility. With increasing ability to predict the disorder, trials for the prevention of diabetes have begun.