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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 18 newly diagnosed diabetic patients (8 males and 10 females, aged 18-26 years, within 10-120 days from the onset of symptoms) who were submitted for 15 days to intensive insulin therapy performed via subcutaneous insulin infusion (CSII). We investigated some metabolic and immunological parameters in order to identify a possible marker to predict the selection of patients potentially more responsive to CSII treatment for the remission of type 1 diabetes. In accordance with the International Diabetes Immunology Group we considered clinical remission as being the withdrawal of insulin therapy for at least 3 months. In order to assess beta-cell function a fasting and post-prandial serum C-peptide, blood glucose and HbA1c were performed on all patients before, and 3 days after, the discontinuation of CSII. Islet cell antibodies were determined in all sera by indirect immunofluorescence. Analysis of T-lymphocyte subpopulations was carried out before starting the therapy. The following monoclonal antibodies were used: CD4, CD8, CD57, CD25, HLA-DR. The levels of C3 and C4 and serum IgG, IgA and IgM were also evaluated. After CSII, 11 of 18 patients showed remission. At the beginning of the study we observed no major difference in metabolic parameters between the two groups. Interestingly, the patients who exhibited remission presented a statistically higher percentage of positive cells for CD57, HLA-DR and CD25 surface antigens, significantly lower C4 levels and CD4/CD8 ratio and significantly higher IgG levels compared with patients who did not show any remission.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:In search of predictive markers of remission from insulin dependence in type 1 diabetes: a preliminary report. 160 Aug 53

In 27 children (15 males and 12 females) with insulin-dependent diabetes mellitus (IDDM), aged 1.2-13.5 years (mean 9.9 +/- 3.6 years) we investigated immunoglobulins (IgG, IgA, IgM), IgG subclass levels and islet-cell antibodies (ICA) at diagnosis and at 6 and 12 months after disease onset. At diagnosis, IgG levels were lower than -2SD in 7 patients (26%), IgA in 1 (3.7%), IgM in 1 (3.7%). IgG subclass levels were below the 3rd percentile in 13 patients (48.1%); in particular IgG1 in 7 (26%), IgG2 in 3 (11.1%), IgG3 in 2 and IgG4 undetectable in 1 case. In 3 out of the 13 patients combined IgG1-IgG3, IgG1-IgG2 and IgG1-IgG4-IgA deficiencies were observed. ICA were greater than 20 Juvenile Diabetes Foundation units in 17/27 patients. The HLA-DR2 frequency was higher in patients with IgG subclass deficiency than in patients with normal IgG subclass levels. During follow up, IgG levels normalized in 6 patients while IgA and IgM did not change. IgG1 normalized in 5 out of the 7 patients, IgG2 in all patients while IgG3 and IgG4 did not change. One year later ICA were still present in 8/27 patients. The hypogammaglobulinaemia and IgG subclass deficiencies observed in our patients could have either a genetic or an acquired basis.
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PMID:Transient IgG subclass deficiencies in newly diagnosed diabetic children. 160 Oct 8

Since the recently reported relationship between serum fructosamine and IgA concentrations appears to throw doubt on the clinical utility of fructosamine as a measure of hyperglycemic status if IgA concentration is not taken into account, we studied serum immunoglobulin concentrations in 169 diabetics and their relationship with various clinical and analytical parameters. Over 41% of the patients studied had abnormal serum IgA concentrations. Serum IgA concentration was negatively correlated with serum albumin, and among IDDM patients was positively correlated with age (so that the prevalence of abnormal IgA was 57.7% among IDDM patients aged over 30 years). Among NIDDM patients, abnormal IgA concentrations were especially prevalent among those being treated with oral hypoglycemics. Abnormal IgA was also more frequently found in both IDDM and NIDDM patients, who had been under treatment for 10 years or more. Abnormal IgG concentrations were found in 11.8% of the diabetics, and the mean IgM concentration found in the patients was 41.6% lower than in the normoglycemic group. We conclude that abnormal serum IgA concentrations are very common in diabetic patients and that further research should be carried out to verify whether the determination of serum immunoglobulins, IgA in particular, is of clinical use for monitoring diabetes or evaluating its secondary effects.
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PMID:Abnormal serum immunoglobulin concentrations in patients with diabetes mellitus. 177 77

IgA and IgG antigliadin antibodies were measured in 498 patients with insulin dependent diabetes mellitus and no history of intestinal malabsorption. Thirty patients had abnormal concentrations of antigliadin antibodies; 22 of these had an intestinal biopsy carried out and 16 of the 22 had subtotal villous atrophy suggestive of coeliac disease (prevalence 3.2%). There were no significant differences between patients with coeliac disease and diabetes and diabetic patients with normal IgA antigliadin antibodies in any of the nutritional variables measured, duration of diabetes, and mean insulin requirement. The mean age of onset of diabetes and attainment of expected height for age were both significantly lower in the patients with both diseases. Typing HLA classes I and II was done in 242 patients. The incidence of HLA-B8, DR3, and DQW2, which are commonly associated with both the diseases, is increased when both are present.
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PMID:Screening of diabetic children for coeliac disease with antigliadin antibodies and HLA typing. 203 7

Another autoimmune disease was found to accompany insulin dependent diabetes mellitus (IDDM) in 14% of the young diabetics (n = 14) studied. Thyroid autoimmune disease was the most common of the accompanying autoimmune diseases, and was detected in 11% (n = 15) of the patients. Two thirds of the IDDM patients with autoimmune thyroiditis were hypothyroid, one was hyperthyroid, and 20% lacked detectable thyroid antibodies when thyroid disease was diagnosed. Coeliac disease was found in 2% of the patients, and one had Addison's disease. Autoantibodies were found in one third of the patients. Thyroid microsomal antibodies were detected in 22% of the patients, IgA anti-gliadin in 11%, gastric parietal cell antibodies in 3% and rheumatoid factor in 7%. Autoimmune disease and the relevant autoantibodies coexisted in 11% of the patients. Autoimmune disorders and autoantibodies were not associated to any particular HLA type. The distribution of the HLA-types in the patients was unusual in that the frequency of HLA-DR3 was not increased. The value of autoantibody tests in the diagnosis of functional disorders of the thyroid and of coeliac disease are discussed.
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PMID:Autoantibodies and autoimmune diseases in young diabetics. 213 5

Circulating autoantibodies to insulin can be detected in patients with insulin-dependent (type I) diabetes mellitus (IDDM) at the onset of the clinical disease. To characterize the autoantibody response in IDDM patients, we determined the frequency of circulating B cells committed to the production of IgM, IgG, and IgA to insulin in 12 newly diagnosed IDDM patients and, for comparison, in 9 healthy subjects and 17 insulin-treated IDDM patients. We found that B cells committed to the production of anti-insulin IgG, but not IgM, autoantibodies are present at much higher frequency in the circulation of newly diagnosed IDDM patients before insulin treatment (0.209 +/- 0.142%, mean value +/- SD of total IgG-producing cell precursors) as compared with age-matched healthy controls (0.032 +/- 0.030% of total IgG-producing cell precursors). In IDDM patients who had been treated with insulin, cells producing IgG antibody to insulin were 0.177 +/- 0.139% of total IgG-producing cell precursors. Generation of IgG mAb from B cells of IDDM patients revealed that they were monoreactive, i.e., they bound to insulin, but to none of the other Ag tested, and displayed a high affinity for insulin (Kd approximately 10(-7) moles/liter). In contrast, the IgG mAb derived from healthy subjects were polyreactive, i.e., they bound to all Ag tested, and displayed a low to moderate affinity for insulin (Kd approximately 10(-5) to 10(-6) moles/liter). These findings show that lymphocytes committed to the production of high affinity IgG autoantibodies to insulin are common in the B cell repertoire at the onset of IDDM.
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PMID:Frequency of B cells committed to the production of antibodies to insulin in newly diagnosed patients with insulin-dependent diabetes mellitus and generation of high affinity human monoclonal IgG to insulin. 215 34

A group of 210 pediatric Type 1 diabetic patients with long duration of illness and their matched controls (age range 2-19 years) were analysed for Coxsackie B4 antibodies in IgG-, IgM- and IgA-antibody classes by enzyme-linked immunosorbent assay (ELISA). About 60% of both patients and controls were seropositive. However, patients had higher prevalence and mean levels of IgA-class antibodies compared to controls. No such difference was found in IgG- or IgM-antibody classes. The elevation of IgA-class antibody levels was evident early after the Coxsackie B4 infection and seemed to persist for several years. IgA-class antibody levels did not differ between sexes in either patients or controls. The elevated levels of IgA-antibodies against Coxsackie B4 virus did not correlate with the elevated IgA antibodies against mumps virus, which served as control antigens. Thus it seems that in IDDM patients the abnormal IgA response against both Coxsackie B4 and mumps virus is antigen-specific.
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PMID:Humoral immunity against viral antigens in type 1 diabetes: altered IgA-class immune response against Coxsackie B4 virus. 242 21

Serum IgA, IgG and IgM levels, spontaneous and pokeweed mitogen (PWM)-induced in vitro IgM production (determined by ELISA) and blastogenic responses of peripheral mononuclear cells to PWM were evaluated in 4 insulin-dependent (IDDM) children, at the onset and after 4, 8, 12 months of disease, and in 32 children and adolescents with IDDM of 1-14 years duration (mean 4.8 +/- 3.8 years). Fifteen age-matched healthy subjects served as controls. Serum immunoglobulin levels were normal in 31 (86%) patients. Spontaneous in vitro IgM production showed no significant difference between IDDM patients and controls. The PWM-stimulated lymphocytes from IDDM patients at onset or after 4 months of disease produced significantly lower concentrations of IgM compared to long-standing IDDM patients or to controls. No different blastogenic response to PWM was observed in IDDM patients compared to controls. No correlation was present between the immunological parameters evaluated and metabolic control. Our data suggest that a defect of antibody producing B lymphocytes or an alteration of T cell can occur during the early stages of diabetes.
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PMID:Spontaneous and pokeweed mitogen-induced in vitro IgM production in children and adolescents with insulin-dependent diabetes mellitus. 263 13

It has been speculated that stressful life events can precipate some autoimmune diseases by altering the immune system. This study was undertaken to test this hypothesis in type I (insulindependent) diabetes. Thirty-two young patients (less than 40 years) with a recently diagnosed IDDM and 53 age-matched controls were interviewed according to a standardized questionnaire designed to identify, date, and weigh past stressful life events. In patients immunological status was assessed during the six months following the first manifestation of the disease by measuring anti-organ and anti-islet cell antibodies, T lymphocyte subsets, PHA mitogenic activity, IL2 production by blood mononuclear cells, IgG, IgA, IgM, and C3, C4 component fraction levels. The diabetic population experienced fewer life events, stressful or non-stressful, but in the 12 months preceding the onset of the disease, 50% of the diabetics endured at least one stressful life event as against only 18.8% of the controls (p less than 0.01). The only difference in the immunological status of the patients who had experienced a stressful life event in the previous twelve months and those that had not, involved PHA mitogenic activity which was significantly lower after a stressful event. While these findings do attest to a temporal relation between stress and type I diabetes in at least 1 out of 2 patients, they do not establish a causative connection.
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PMID:Stress antecedents and immune status in recently diagnosed type I (insulindependent) diabetes mellitus. 265 29

The IgA antigliadin antibodies AGA title was detected in 37 patients with IDDM, mean age 32.59 +/- 14.71, where mean duration of disease was 8.76 +/- 9.62 years, and 29 patients with NIDDM, mean age 55.31 +/- 14.71, where disease lasted 11.5 +/- 5.55 years. A group of 51 normal pts. was employed as control. In IDDM group 2 cases on 37 showed high AGA title (case n. 1 and n. 2) but just the case n. 1 where IDDM lasted 16 years, showed an histologic picture of coeliac disease (partial villous atrophy), while in the case n. 2 where IDDM was at the onset, the histologic picture was normal. The increase of AGA title in the IDDM at the onset is rarely associated with coeliac disease, but it seems to be an aspecific response. Viceversa an increased AGA title is in IDDM for greater than 1 years often associated with coeliac disease. In NIDDM no high AGA title was found. The prevalence of coeliac disease in our patients with IDDM was 1:37 and we suggest that diabetics be screened routinely for antigliadin antibody.
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PMID:[Celiac disease in insulin-dependent diabetes mellitus and insulin-independent diabetes mellitus]. 271 Oct 15


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