Gale E A
Diabetes and Metabolism, Division of Medicine, University of Bristol, UK.
Diabetes. 2001 Feb;50(2):217-26. doi: 10.2337/diabetes.50.2.217.
The etiological heterogeneity of idiopathic diabetes has been recognized for 25 years, and subdivision into type 1 and type 2 diabetes is fundamental to the way we think about the disease. Review of the literature suggests that the concept of type 1 diabetes as an immunemediated disease emerged rapidly over the period from 1974 to 1976 and showed many of the features of a classic paradigm shift. A few key observations triggered recognition and acceptance of the new paradigm, but the necessary context was provided by scientific developments in areas mainly unrelated to diabetes. The disease paradigm established by 1976 is still widely accepted, and its essential features have been modified only in detail by the revolution in molecular biology that has occurred over the intervening period. Notwithstanding, some of the underlying assumptions remain imprecise, unchallenged, or unconfirmed. Appreciation of the historical origin and subsequent evolution of these fundamental concepts could stimulate critical analysis and help prepare the way for a new paradigm.
特发性糖尿病的病因异质性已被认识25年了，将其细分为1型和2型糖尿病是我们思考该疾病方式的基础。文献回顾表明，1型糖尿病作为一种免疫介导疾病的概念在1974年至1976年期间迅速出现，并展现出许多经典范式转变的特征。一些关键观察结果引发了对新范式的认识和接受，但必要的背景是由主要与糖尿病无关领域的科学发展提供的。1976年确立的疾病范式仍被广泛接受，其基本特征仅在随后分子生物学革命期间得到了细节上的修正。尽管如此，一些潜在假设仍不精确、未受质疑或未经证实。了解这些基本概念的历史起源和后续演变可能会激发批判性分析，并有助于为新范式铺平道路。
