Proposed Guidelines on Screening for Risk of Type 1 Diabetes
- Polly J. Bingley, MD, FRCP,
- Ezio Bonifacio, PHD,
- Anette-G. Ziegler, MD,
- Desmond A. Schatz, MD,
- Mark A. Atkinson, PHD,
- George S. Eisenbarth, MD, PHD and
- the Immunology of Diabetes Society
- From the Division of Medicine (P.J.B.), University of Bristol, Bristol, U.K.; the Institutio Scientifico San Raffaele (E.B.), Milan, Italy; the Diabetes Research Institute (A.-G.Z.), Krankenhaus München-Schwabing, Munich, Germany; the Departments of Pediatrics (D.A.S.) and Pathology (M.A.A.), University of Florida College of Medicine, Gainesville, Florida; and the Barbara Davis Center for Childhood Diabetes (G.S.E.), University of Colorado Health Sciences Center, Denver, Colorado.
- Address correspondence and reprint requests to Dr. Polly Bingley, Medical School Unit, Southmead Hospital, Bristol BS10 5NB, U.K. E-mail: polly.bingley{at}bristol.ac.uk .
These guidelines represent the recommendations of the Immunology of Diabetes Society (IDS) on the assessment of risk of type 1 diabetes in unaffected first-degree relatives of patients with the disease, and are based on the consensus reached at a symposium held at the fourth meeting of the IDS (Fiuggi, Italy, November 1999).
Assessment of risk of type 1 diabetes in relatives was initially based on detection of circulating islet cell antibodies (ICAs) supplemented by measurement of insulin autoantibodies (IAAs), and evaluation of β-cell function by determination of the first-phase insulin response (FPIR) in the intravenous glucose tolerance test. Other islet autoantigens, including GAD and the protein tyrosine phosphatase IA-2/ICA512, have subsequently been identified, and the role of autoantibodies to these antigens in assessment of risk of type 1 diabetes in first-degree relatives has been investigated in a number of large prospective studies. In addition, the genetic susceptibility to type 1 diabetes, particularly that conferred by genes in the HLA class II region, has been …
