Islet Autoantibodies and Type 1 Diabetes: Does the Evidence Support Screening?

Type 1 diabetes (T1D)3 is a chronic progressive auto-immune disorder with complex polygenic susceptibil-ity, usually associatedwith certainHLAalleles (IDDM1 locus). Environmental factors, which are poorly de-fined, also contribute to the pathogenesis. T1D is char-acterized by lymphocyte infiltration into the islets of Langerhans in the pancreas, leading to inflammation and selective destruction of the insulin-producing -cells, resulting in hyperglycemia (1). Patients with T1D fail to produce insulin and are dependent on ex-ogenous insulin to maintain life. Although it is consid-erably less common than type 2 diabetes, the world-wide prevalence of T1D is increasing by approximately 3 % per annum. The incidence varies widely among countries. In Americans under the age of 20 years, th