Jay S Skyler

University of Miami, Florida 33136, USA Type 1 diabetes is characterized by immune-mediated pancreatic islet B-cell destruction, absolute insulin deficiency, and thus dependence on insulin therapy for the preservation of life1. The type 1 diabetes disease process involves (1) a genetic predisposition, conferred principally by 'diabetogenic' genes in the major histocompatibility complex (MHC) on the short arm of chromosome 6 (2) non-genetic (environmental) factors that appear to act as triggers...

Prevention Of Type Diabetes

Interventions have been targeted at altering a number of behavioral factors including obesity, dietary intake and physical activity. Obesity, of course, should be considered the result of behavioral, genetic and physiological factors and not simply behavioral. Pharmacological interventions have primarily used hypoglycemic or anti-hyperglycemic medication to reverse insulin resistance biguanides, thiazolidenediones , failure of insulin secretion sulfonylureas , or glycemic excursions...

References

Atkinson MA, Maclaren NK 1994 The pathogenesis of insulin dependent diabetes mellitus. New England Journal of Medicine 331 1428-1436. 2. Skyler JS 1987 Immune intervention studies in insulin-dependent diabetes mellitus. Diabetes Metabolism Reviews 3 1017-1035. 3. Pozzilli P 1988 Immunotherapy in type 1 diabetes. Diabetic Medicine 5 734-738. 4. Harrison LC, Campbell IL, Colman PG, Chosich N, Kay TWH, Tait BD, Bartholomeusz RK, DeAizpurua HJ, Joseph JL, Chu S, Kielczynski WE 1990 Type 1...

P

Primary Prevention Diabetes Program, Madras, India 262 persons with family history of diabetes, followed for at least 4 years, pre-post analysis. Outcome diabetes Diet High-carbohydrate, low-fat 20 . Exercise primarily 30 minutes per day walking Persons who increased weight versus lost weight or kept stable weight were 5.1 2.6-13.9 times more likely to develop diabetes, adjusted for baseline glucose and gender. Second analysis of similar smaller subset119 found persons with normal OGTT more...

USA

Outcome diabetes mortality Gothenburg, Sweden 1154 women. Outcome clinical diabetes or fasting glucose gt 7.0 mmol L Seven Countries Study, Finnish and Dutch cohorts 338 nondiabetic men, 1970-1990. Outcome 2 h glucose Rotterdam, Netherlands, general practice 175 normoglycemic persons. Outcome OGTT, IGT diabetes Rotterdam, Netherlands, general practice 175 normoglycemic persons. Outcome OGTT, IGT diabetes San Antonio Heart Study, Texas, USA 1093 Mexican-American and nonHispanic...

Oral Glucose Tolerance Test

The oral glucose tolerance test OGTT has for many years been the accepted standard for the diagnosis of diabetes. It is, however, time consuming and inconvenient requiring considerable preparation. Many would therefore regard it as unsuitable for widespread use among people with risk factors for diabetes. Unless conducted in the inpatient setting, the recent dietary intake and duration of the pre-test fast cannot be standardised in the way the protocol demands, and these factors can affect the...

Contributors List

Diabetes Trials Unit, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6EH, UK Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0607, USA Medicine, Obstetrics and Gynaecology, and Physiology and Biophysics, USC Keck School of Medicine, 6602 General Hospital, 1200 N States Street, Los Angeles, CA 90089-9317, USA 1500 East Medical Center Drive, Division of Cardiology, Level B1, Ann Arbor, Michigan 48109, USA Office of the WHO...

Info

120 men aged 25-55 years x 45 with borderline glucose tolerance follow-up 2 years. Outcome OGTT 0.85g bid G B N 29 Placebo N 33 204 men with borderline glucose tolerance aged 40-64 years x 57 follow-up 5 yrs. Outcome diabetes incidence 73 persons with borderline or chemical diabetes aged 23-74 x 54 follow-up 5 yrs. Outcome OGTT 457 subjects with high waist-hip ratio, aged 120 g day carbohydrate Phenformin N 49 Biguanide no effect on glucose and insulin significant weight loss. Glibenclamide no...

Autoantibodies

A number of circulating autoantibodies to islet cell markers may be detected at diagnosis of type 1 diabetes. Indeed, current classification of diabetes uses the presence of autoantibodies to define type 1 diabetes or autoimmune diabetes the exception being those individuals prone to ketoacidosis but without antibodies, classified as type 1 idiopathic 33. The autoantibodies include cytoplasmic islet cell antibodies ICA , insulin autoantibodies IAA , and antibodies directed against glutamic acid...