Weets I, Truyen I, Philips J C, Gorus F
Registre Belge du Diabète, Avenue du Laerbeek 101, 1090 Bruxelles.
Rev Med Liege. 2005 May-Jun;60(5-6):306-12.
The pathological process of type 1 diabetes starts many years prior to clinical diagnosis and is often accompanied by the appearance of circulating autoantibodies directed against islet cell antigens. Once diagnosed, insulin substitution therapy cannot totally prevent the development of chronic complications of hyperglycaemia. Efficient intervention aims at preventing the development of chronic complications. All antibody-positive subjects do not necessarily develop type 1 diabetes and, in case of progression, the destruction kinetics of beta cells may vary from one individual to another. Therefore, it is important to characterise and follow large representative groups of patients and subjects at risk (e.g. first degree relatives of patients with type 1 diabetes) to define selection criteria for subjects with an homogeneous risk of diabetes (and thus of complications) and consider a prevention strategy. The Belgian Diabetes Registry (BDR) has collected epidemiological, clinical and biological data from more than 4000 patients and more than 7000 first degree relatives. The detection of immune, genetic and hormonal markers allows to identify subjects at risk of rapid destruction of residual beta cells in view of their participation in prevention trials.
1型糖尿病的病理过程在临床诊断前许多年就已开始，并且常常伴随着针对胰岛细胞抗原的循环自身抗体的出现。一旦确诊，胰岛素替代疗法并不能完全预防高血糖慢性并发症的发生。有效的干预旨在预防慢性并发症的发生。并非所有抗体阳性的个体都会发展为1型糖尿病，而且如果病情进展，β细胞的破坏动力学在个体之间可能会有所不同。因此，对大量具有代表性的患者群体和高危人群（如1型糖尿病患者的一级亲属）进行特征描述和随访，以确定具有相同糖尿病风险（以及并发症风险）的受试者的选择标准，并考虑预防策略，这一点很重要。比利时糖尿病登记处（BDR）已经收集了4000多名患者以及7000多名一级亲属的流行病学、临床和生物学数据。鉴于免疫、遗传和激素标志物参与预防试验，对它们的检测有助于识别残余β细胞有快速破坏风险的受试者。
