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Etiology
The absence of insulin characterizes Type 1. Individuals with Type 1 must take insulin shots to live. The etiology of Type 1 is a combination of genetic and environmental factors. Recently, Type 1 was divided into two categories, (a) immune-mediated diabetes (resulting from an autoimmune destruction of ß-cells) and (b) idiopathic diabetes (rare forms without a known cause). (5)
Autoimmune Destruction
Individuals diagnosed with Type 1, show signs of pancreatic ß-cell destruction prior to diagnosis. Autoantibodies, which destroy pancreatic cells, may be present up to nine years before a diagnosis of Type 1. The rate of ß-cell destruction is highly variable. Hyperglycemia would indicate that enough destruction of ß-cells had taken place as to prevent adequate insulin secretion.
Dr. Mark Atkinson, University of Florida and Dr. Daniel Kaufman, University of California Los Angeles, suggest that autoimmune destruction of GAD is the first phase in the subsequent destruction of ß-cells. These researchers successfully prevented the destruction of ß-cells by inactivating the autoimmune response to GAD. (3,8,11,17,18)
Idiopathic Diabetes
Individuals who have no evidence of an autoimmune disorder, but present with destroyed ß-cells are identified as having "idiopathic diabetes". This form of Type 1 is considered rare. (18)
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