October - December 2015, Volume 11, Issue 4

Ionescu-Tîrgoviste C

What is Before the Autoimmune Seroconversion in Type 1 Diabetes?

Acta Endo (Buc) 2015, 11 (4): 419-424
doi: 10.4183/aeb.2015.419

In the past years a high interest has been observed for understanding the early stages of type 1 diabetes. That interest has been stimulated by the failures of the various “preventive” approaches of the autoimmune mechanism operating in this phenotype, carried out in young diabetic patients, soon (several months) after the clinical onset of the disease. Unfortunately, the recent Statement of three scientific organisations from the USA proposed a reconsideration of the well-known classical stages, not going backward to know better the true early onset of the autoimmunity, but refining only the second part of the classical stages which are closer to the clinical onset of diabetes (when the β-cell mass/function is about 70% already irreversibly lost). In opposition with the above mentioned initiative, our effort has been devoted to the detection of earlier stages of diabetes which silently operate before the detection of the first islet autoantibodies (mainly proinsulin/insulin antibodies) which strangely was omitted in the new mentioned reclassification of preclinical stages of type 1 diabetes.

Keywords: type 1 diabetes, autoimmunity, prediction, prevention.

Correspondence: Constantin Ionescu-Tirgoviste MD, PhD, National Institute of Diabetes, “N.C. Paulescu” Nutrition and Metabolic Diseases, I. Movila 5-7, Bucharest, 020475, Romania, E-mail: cit@paulescu.ro