Köbberling J
Z Gesamte Inn Med. 1981 Jun 1;36(11):360-3.
Diabetes is genetically heterogeneous. The subdivision of idiopathic diabetes should better be performed according to the necessity of treatment (dependence on insulin) than according to the age in the primary manifestation. Up to now only few genetic entities are clinically defined, and a coordination to certain types is often difficult in the individual case. Altogether the genetic load is clearly smaller in the insulin-dependent diabetes. The risk for children of insulin-dependent diabetics is only about 1-2%. Since the risk of disease for children of young non-insulin-dependent diabetics is about 50%, a clear clinical diagnostics of the mothers within the consultation is important. However, there are no reliable genetic markers for an exact subdivision into types in the individual case. The association of certain HLA-types with insulin-dependent diabetes is theoretically of great interest and refers to the participation of autoimmunological phenomena in the development of this type of diabetes. However, the estimation of HLA is not helpful for the consideration of individual cases, also within a genetic consultation. the existing heterogenias within the non-insulin-dependent diabetes are not yet sufficiently clarified. This type is altogether much more genetically determined, particularly when it appears in younger age and when it is not associated with adiposity.
糖尿病具有遗传异质性。特发性糖尿病的细分最好根据治疗需求（对胰岛素的依赖程度）进行，而不是根据初次发病时的年龄。到目前为止，临床上仅定义了少数遗传实体，在个体病例中往往难以与特定类型进行匹配。总体而言，胰岛素依赖型糖尿病的遗传负荷明显较小。胰岛素依赖型糖尿病患者子女的患病风险仅约为1-2%。由于年轻的非胰岛素依赖型糖尿病患者子女的患病风险约为50%，因此在咨询过程中对母亲进行明确的临床诊断很重要。然而，在个体病例中，尚无可靠的遗传标记用于精确分型。某些HLA类型与胰岛素依赖型糖尿病的关联在理论上具有重要意义，提示自身免疫现象参与了此类糖尿病的发生发展。然而，HLA检测对个体病例的评估并无帮助，即使在遗传咨询中也是如此。非胰岛素依赖型糖尿病中现有的异质性尚未得到充分阐明。这种类型总体上受遗传因素影响更大，尤其是在发病年龄较轻且与肥胖无关时。
