Autoimmunity to islet cells in diabetes mellitus.

Current evidence indicates that Type I diabetes mellitus is a slowly progressive autoimmune disease resulting in complete beta-cell destruction in genetically susceptible individuals. Histocompatibility region genes are major determinants of genetic susceptibility, and more than 90% of Type I individuals express HLA alleles DR3 or DR4. Prior to clinical diabetes, islet-cell antibodies and activated T lymphocytes are found in conjunction with a slowly progressive loss of intravenous glucose-stimulated insulin secretion. Present clinical research efforts are aimed at detection of susceptible individuals prior to the development of diabetes and selective immunotherapy to halt beta-cell destruction.