Chapter

Classification and aetiology

David Levy

in Type 1 Diabetes

Published on behalf of Oxford University Press

ISBN: 9780199553211
Published online September 2011 | e-ISBN: 9780191740190 | DOI: http://dx.doi.org/10.1093/med/9780199553211.003.0001

Series: Oxford Diabetes Library

Classification and aetiology

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• Type 1 diabetes is a common complex autoimmune condition especially prevalent in Caucasian white northern and southern populations. • Incidence is increasing rapidly, especially in the under 5 age group; cases are likely to double in northern countries between 2005 and 2020. • High-risk human leucocyte antigen haplotypes are carried by more than 90% of Type 1 patients; protective haplotypes also exist. • Latent autoimmune diabetes in adults (LADA) is frequent in older people with phenotypic features of Type 2 diabetes. It is an important diagnosis to make whenever possible at onset to raise awareness of the requirement for insulin treatment. • Tests for islet antibodies (glutamic acid decarboxylase, islet cell, and IA-2) can be valuable in the diagnosis of LADA, and are used to rapidly screen large high-risk populations. • Up to now, primary and secondary intervention trials have been mostly unsuccessful, but tertiary intervention in the period immediately following clinical diagnosis shows much more promise, and an international programme (www.diabetestrialnet.org) of clinical trials in newly-diagnosed patients (and studies of prevention in close relatives) is exploring new interventional agents.

Chapter.  4063 words.  Illustrated.

Subjects: Endocrinology and Diabetes

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