Type 1 diabetes in Japan

Abstract

Type 1 diabetes is a multifactorial disease which results from a T-cell-mediated autoimmune destruction of the pancreatic beta cells in genetically predisposed individuals. The risk for individuals of developing type 1 diabetes varies remarkably according to country of residence and race. Japan has one of the lowest incidence rates of type 1 diabetes in the world, and recognises at least

Differences in the humoral autoreactivity to zinc transporter 8 between childhood- and adult-onset type 1 diabetes in Japanese patients

“…In patients with slow-onset type 1 diabetes, insulin treatment was initiated > 1 year after the diagnosis of diabetes by the positive urine glucose test or the development of hyperglycemic symptoms [7]. Diagnostic criteria for fulminant type 1 diabetes were 1) ketosis or ketoacidosis within a week after the onset of hyperglycemic symptoms, 2) plasma glucose level ≥ 16 mM and HbA1c < 8.5% at the first visit, and 3) urinary C-peptide level < 10 µg/day, fasting serum C-peptide level < 0.3 ng/ml or serum C-peptide < 0.5 ng/ml after glucagon or a meal load [3]. Of 97 AO patients, 54 (55.7%) were acute-onset, 28 (28.9%) were slow-onset, and 15 (15.5%) had fulminant type 1 diabetes.…”

“…Those include slow-onset and fulminant type 1 diabetes [3]. Although the different clinical phenotypes may depend on the extent of β cell destruction, the underlying immune mechanisms are largely unknown.…”

Slowly progressive insulin-dependent (type 1) diabetes positive for anti-GAD antibody ELISA test may be strongly associated with a future insulin-dependent state

“…In terms of the onset pattern of hyperglycemia, type 1 DM can be classified into three types; i.e., acute-onset, slowly progressive and fulminant type 1 DM [3,4]. The presence of GADA or ICA in diabetic patients in non-insulin-dependent state strongly suggests a diagnosis of slowly progressive insulin-dependent (type 1) DM (SPIDDM) [5].…”

Case of Type 1 Diabetes Mellitus Following Interferon β-1a Treatment for Multiple Sclerosis

“…The MHC region, specifically the HLA class II genes, are the primary genetic loci associated with type 1 diabetes mellitus (21,22). In the present case, the patient had HLA-DRB1*0405, which is a type 1 diabetes mellitus susceptibility HLA-DR in the Japanese population (23). She had also HLA-A24, which is another factor implicated in the destruction of pancreatic β cells (24), and HLA-B54, which is associated with type 1 diabetes mellitus in Japanese (25).…”