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Das Christentum gehort von Anfang an zur DNA der CSU. Seit 1945 ist dies durchgangig in ihren zentralen programmatischen Dokumenten fassbar. Dabei verstand sich die Partei ebenso schon von Beginn an als explizit interkonfessionelle Partei, um die auch in Bayern spurbaren Grenzen zwischen Katholizismus und Protestantismus zu uberwinden. Mit ihrem interkonfessionellen Geprage hat sie dabei nicht nur konkrete Politikfelder beeinflusst, sondern im Sinne einer ubergreifenden christlichen Ethik vor allem die Grundfesten der politischen Ordnung und die Regeln politischen Miteinanders.

Der vorliegende Band will sich den gegenwartig so kontrovers diskutierten Verbindungslinien zwischen Religion und Politik theoretisch, ideengeschichtlich und empirisch nahern. Dazu stellen die versammelten Beitrage die ubergreifende Frage, inwiefern Religionen allein deswegen eine unvermeidlich politische Dimension besitzen, als sie sich ihren jeweiligen historisch-politischen Kontextbedingungen standig neu anpassen (bzw. ihren Offenbarungsanspruch immer wieder neu entdecken und erhalten) mussen, um als Glaubensrichtung Bestand und ‚Erfolg‘ zu haben: Das Erkenntnisinteresse konzentriert sich insofern nicht darauf, ob Religionen eigentlich politisch sind oder sein durfen, sondern wie sich ihre nicht zu eliminierende politische Dimension ausert und kontinuierlich wandelt. Dabei gehen wir davon aus, dass in erster Linie soziopolitische Konflikte dafur ausschlaggebend sind, wenn sich Religionsgemeinschaften zu entsprechenden Reaktionen und Neubeschreibungen veranlasst sehen. Letzteres gilt umso mehr, sobald sie als politische Akteure an solchen Konflikten aktiv beteiligt sind.

Forty-three newly diagnosed diabetic patients from Ethiopia were studied for the frequency of islet cell surface antibodies and other clinical features which are relevant to the aetiopathogenesis and classification of diabetes mellitus. In preliminary investigations of a small number of controls and noninsulin-dependent diabetics we found, as expected, no circulating antibodies. Four first-degree relatives of ICSA-positive sibs were negative, too. However, 3 out of 7 known insulin-treated diabetics displayed ICSA in the blood serum. In our study of newly diagnosed diabetics we found ICSA in 39% (17/43). Five patients who were assigned to the NIDDM subclass had no antibodies. 37 diabetics required insulin treatment after clinical diagnosis and 16 (43%) of these were ICSA-positive. There were no differences in the assessed clinical parameters between ICSA-positive and -negative patients. One ICSA-positive patient initially controlled with oral hypoglycaemic agents became insulin-dependent within our study period. Our observations in newly diagnosed diabetics from Ethiopia revealed a lower frequency of ICSA than in Caucasians, however, the results provide evidence for the occurrence of auto-immune phenomena in the aetiopathogenesis of diabetes mellitus in this ethnic group.

In order to assess the validity of WHO criteria for the discrimination between Type I and Type II diabetes a cross-sectiona clinical study was performed in 84 normweight newly diagnosed diabetics with a mean age of 22 years. Taking into consideration clinical and biochemical characteristics of the carbohydrate and fat metabolism, the therapeutic requirement to maintain euglycemic metabolic control, the residual beta-cell function, the HLA phenotype and islet cell antibodies (ICA, ICSA) it could be shown that none of the tested criteria has the ability to distinguish between the types with absolute certainty. As shown by the frequency of the different markers in relation to the therapeutic requirements for euglycemic metabolic control as well as by the correlation analysis between the variables the discriminating validity of the markers decreased in the following sequence: diabetes associated HLA phenotype, residual beta-cell function, proneness to ketosis, age at onset, relative body weight. Neither the characteristics of the carbohydrate and fat metabolism nor the presence of islet cell antibodies contributed much to the differentiation between insulin-dependent and noninsulin-dependent diabetes.

Two types of insulin pens MADI and MD, were connected to subcutaneous catheters. These "catheter-pens" were used like hand-driven insulin pumps. Results after 1 year of treatment in 30 type 1 diabetics (HCP-negative; age at onset of diabetes 16.5 +/- 1.7 years; duration of diabetes 18.5 +/- 1.6 years, on multiple insulin injections before catheter-pen application): 1. better quality of life (reduction of frequency of needle pricks, more flexibility, inconspicuous application of insulin in public); 2. daily insulin--increased number of "injections" (4.2 +/- 0.1 vs 5.8 +/- 0.1, p less than 0.01), reduction of units per kg BW (0.70 +/- 0.02 vs 0.60 +/- 0.01, p less than 0.01), reduction of intermediate-acting insulin (14.1 +/- 1.3 vs 9.2 +/- 1.2 U/d, p less than 0.05); 3. no change of HbA1 (10.8 +/- 0.8 vs 10.2 +/- 0.2%, normal range 7.7 to 8.4%), mean blood glucose (MBG) in stress situation (8.4 +/- 0.4 vs 7.7 +/- 0.3 mmol/l), serum cholesterol and body weight, both within normal range; 4. improvement (p less than 0.05) of serum triglycerides, serum HDL-cholesterol, ratio of apolipoprotein A1/B; 5. rare skin reactions at the needle site. Conclusion. Catheter-pens offer a very convenient alternative for insulin administration in intensified conventional insulin treatment with multiple injections in type 1 diabetics.

It has been suggested that the mumps virus may be involved in the etiopathogenesis of Type-I diabetes mellitus. Most studies have analyzed this relationship retrospectively. We, however, carried out a prospective study over a 4 year period after a mumps infection in two age groups (16 years and under [group A no = 32] and over 16 years [group B no = 18]). These subjects with "diabetic risk factors" (impaired glucose tolerance, low insulin response, ICSA and/or HLA-DR3/DR4) were selected from 1581 registered cases, in whom an antecedent mumps infection had occurred in 1980 and 1981. Glucose tolerance and insulin secretion did not change significantly during 4 years after a mumps infection. Overt diabetes was not observed in any of the cases. One year after a mumps infection 35% of children and 63% of adolescents/adults exhibited ICSA (control subjects = 5%; a serum was considered ICSA-positive if more than 25% of the intact rat islet cells showed distinct cell surface immunofluorescence). After 4 years the percentage of subjects with ICSA decreased significantly to 13% and 14%, resp. Only 21% of ICSA-positive sera were found to be cytotoxic on rat islet cells (51Cr-release assay). No relationship could be evaluated between complications resulting from a mumps infection and the appearance of ICSA. There was no correlation between ICSA, glucose tolerance, and insulin secretion. In fact, our prospective study did not reveal any relationship between a mumps infection and Type-I diabetes. ICSA would seem to be of no predictive value.

Konfessionell grundierte „Gesinnungskampfe“ durchziehen als Basso continuo das 19. Jahrhundert. Nachdem sich zunachst Wien als eines der geistigen Zentren der katholischen Bewegung etabliert hatte, verlagerte sich das Gewicht unter dem Einfluss von Konig Ludwig I. dann zunehmend auf die bayerische Hauptstadt. Mit Ausgang der Zwanzigerjahre avancierte die Stadt an der Isar „zum politischen, wissenschaftlichen und ideologischen Mittelpunkt des katholischen Deutschland“. Masgeblich mitverantwortlich fur diese Entwicklung und auf zwei Jahrzehnte hinaus auch ihr geistiger Mittelpunkt war Joseph Gorres, „der vom Jakobinismus zur Mystik konvertierte Kampfer fur die Freiheit der Kirche von staatlicher Bevormundung“.

A study was made of glucose tolerance and insulin secretion in 33 persons who later developed insulin-dependent diabetes (aged 4-24 years) and observation continued further in the first years after manifestation. Patients who developed the typical labile type of diabetes were of normal weight and had either normal glucose tolerance tests before diagnosis or had impaired glucose tolerance (IGT) for a short interval of 2-16 months. Subjects with IGT over a significantly (p less than 0.01) longer period of 32.30 +/- 6.25 (normal body weight) or 94.71 +/- 20.62 (obese) months developed a milder form of diabetes with retarded insulin dependency in obese subjects. The severe and mild form of IDDM are distinct with respect to insulin requirement (0.75 +/- 0.03 or 0.28 +/- 0.04 U/kg b.w., P less than 0.01) and glucagon stimulated C-peptide (0.18 +/- 0.05 or 1.41 +/- 0.27, P less than 0.01) in the first 2.5-3.5 years after onset. The two forms were not different regarding HLA-DR antigens. Islet cell surface antibodies investigated in 15 probands at 27 occasions before diabetes onset had no prognostic value. The development of a mild form of IDDM may be expected in cases with pre-existing IGT for more than one year. The insulin secretion is of low predictive value under these conditions. The observation is of practical use and theoretical interest.

Within 3 days the 2-hour glucose infusion test (GIT) and the 50gm oral glucose tolerance test (oGTT) were performed in 113 normal weight and 33 obese persons suspected to protodiabetes and in 14 control subjects respectively. The results are compared with criteria from a group of healthy persons without any heredity of diabetes worked out in our laboratory. In about 66 per cent of the investigated subjects a concordance between both tests could observed in carbohydrate tolerance. Abnormal results were found more frequently after the oral glucose application. From these finding it was concluded a higher sensitivity of the oGTT. On the other hand followup studies of the disagreed diagnosis have shown that in 91 per cent the test results of the GIT were reproduced. The insulin secretion pattern agreed in 70 per cent between both tests. Whereas the insulin secretion pattern during the oGTT does not allowed to differ between the groups using the glucose infusion test we were able to observe a significant diminished hormone release in the initial as well as in the late phases, if the carbohydrate tolerance was pathologically. Summarizing the results we concluded that the GIT is characterized by a good reproducibility and a higher diagnostic importance than the 50 gm oGTT.

On the basis of the results of clinico-experimental examinations and of animal experiments the importance of obesity as metabolic factor of risk is confirmed and hereby the diabetes mellitus as well as cardiovascular effects are particularly taken into consideration. Conclusions are made relevant to practice and it is particularly referred to the central position of the B-cells for the pathogenesis of diabetes as well as to prophylactic and early therapeutic measures.

In a cross-sectional study comprising of 56 patients with newly diagnosed insulin-dependent diabetes mellitus (IDDM) serum was examined for the presence of complement-dependent antibody mediated cytotoxicity (C'AMC) by an improved assay measuring the release of 51Cr from freshly isolated normal rat islet cells prelabeled with the isotope. In the presence of complement, 35 (63%) IDDM sera specifically mediated cytotoxicity against islet cells. The degree of cell specificity was tested using prelabeled exocrine cells, but this cell type did not reveal any differences between the lytic effects of IDDM and control serum. At the time of clinical onset of IDDM the age of the patients, fasting and stimulated C-peptide levels, insulin requirement, HLA antigens, antibodies to Coxsackie B1-6 viruses, diabetes heredity, and, surprisingly, islet cell surface antibodies (ICSA) were not associated with C'AMC. It is concluded that the mere presence of C'AMC against rat islet cells at the time of diagnosis of IDDM is not indicative of a low residual B cell function and HLA-linked susceptibility to diabetes does not necessarily include enhancement of humoral anti-islet cell autoimmunity. More elaborate methods for quantitative detection of C'AMC and ICSA (e.g. in terms of titres) together with autoantibody subclass determination are needed to reveal possible associations between C'AMC and the clinical characteristics of IDDM.

In 19 insulin-dependent diabetics under compensated metabolic conditions the influence of a highly-dosed short-term vitamin C-treatment with 2,000 mg of ascorbic acid on the carbohydrate and fat metabolism was examined during a stay in hospital. Under the treatment with vitamin C low concentrations of blood glucose in the daily profile are observed, in which case this effect of ascorbic acid on the carbohydrate metabolism cannot be statistically ascertained. Triglyceride, cholesterol, FFA-concentrations and glycerol concentrations are not influenced.

Children of diabetic mothers are a high-risk group. The perinatal mortality and the malformation frequency of the newborns as well as the psychosomatic, somatic and speech development during childhood until the age of 15 were statistically significantly influenced by quality of metabolic compensation, toxaemia and urinary tract infections during pregnancy. To evaluate the diabetogenic risk in children of diabetic mothers metabolic follow-up studies were performed. A statistically significant insulin-high-response without disturbed carbohydrate tolerance was seen in 25% after intravenous glucose infusion and in 28% after oral glucose load. 17% exhibited a paradoxical growth hormone reaction, while the intravenous glucose tolerance and the insulin secretion was in the normal range. Both symptoms could be early diabetic signs in children of diabetic mothers. The oGTT had pathological results in 18% and the glucose infusion test in 8%.

Despite the existence of circumstantial evidence, a direct proof of an autoimmune basis for beta cell destruction in human type I diabetes has not yet been obtained. The present study was designed to test on Wistar rats whether a low-dose streptozotocin (SZ) treatment in combination with complete Freund's adjuvant (CFA) could be a useful approach to induce an autoimmune response to beta cells. Rats were weekly injected i.p. either with CFA or with SZ alone or with both CFA and SZ. Only the SZ-CFA-treated rats developed severe hyperglycemia. In these animals the pancreatic insulin content was nearly completely depleted. Only in SZ-CFA-treated rats cytotoxic autoantibodies to islet cells were found. The results show that in this new model of type I diabetes autoimmune reactions are involved in the destruction of beta cells.

In twenty-four non-obese male subjects a 2-hour glucose infusion test (12 mg/kg/min) with initial bolus injection (0.33 g/kg) was performed as a test of carbohydrate tolerance. Sixteen individuals had a normal and eight a pathological carbohydrate tolerance (asymptomatic diabetes). All subjects received a one-hour insulin infusion (two 30-minutes periods of 8 or 16 mU/kg MC-Actrapid). After two days subcutaneous adipose tissue was removed from the abdominal wall by needle biopsy for characterization of insulin-stimulated (1-14C) glucose incorporation into triglycerides. Under in vivo conditions insulin provoked a decrease of blood glucose concentrations by 31 +/- 3.9% and 11.6 +/- 2.2% as well as of plasma free fatty acids levels by 60 +/- 4.6% and 37 +/- 6.8% in normal persons and asymptomatic diabetics, respectively (p less than 0.01). In vitro the insulin-stimulated incorporation of labeled glucose into triglycerides of adipose tissue was diminished in asymptomatic diabetics. Thus, the results indicate that both the in vivo insulin responsiveness and the in vitro insulin sensitivity of adipose tissue are reduced in early stages of diabetes. The findings suggest that changes in insulin target tissues are equally important in the development of carbohydrate intolerance in non-obese subjects.

Forty-three newly diagnosed diabetic patients from Ethiopia were studied for the frequency of islet cell surface antibodies and other clinical features which are relevant to the aetiopathogenesis and classification of diabetes mellitus. In preliminary investigations of a small number of controls and noninsulin-dependent diabetics we found, as expected, no circulating antibodies. Four first-degree relatives of ICSA-positive sibs were negative, too. However, 3 out of 7 known insulin-treated diabetics displayed ICSA in the blood serum. In our study of newly diagnosed diabetics we found ICSA in 39% (17/43). Five patients who were assigned to the NIDDM subclass had no antibodies. 37 diabetics required insulin treatment after clinical diagnosis and 16 (43%) of these were ICSA-positive. There were no differences in the assessed clinical parameters between ICSA-positive and -negative patients. One ICSA-positive patient initially controlled with oral hypoglycaemic agents became insulin-dependent within our study period. Our observations in newly diagnosed diabetics from Ethiopia revealed a lower frequency of ICSA than in Caucasians, however, the results provide evidence for the occurrence of auto-immune phenomena in the aetiopathogenesis of diabetes mellitus in this ethnic group.

Mouse monoclonal antibodies producing cell lines were generated against rat and human islet cells by somatic cell hybridization using the mouse myeloma cell line P3-X63-Ag8. Four hybrid cell lines are growing as ascites bearing tumors. All four monoclonal antibodies reacted with cytoplasmic islet cell antigens as detected by the indirect immunofluorescence technique on Bouin-fixed pancreatic sections of Wistar rats. Besides their binding to cytoplasmic antigens three of them also recognized antigens expressed at the islet cell surface. Moreover, two of these three monoclonal antibodies were capable of mediating complement dependent cytotoxicity against rat islet cells as revealed in a 51Cr-release assay.

In order to assess the validity of WHO criteria for the discrimination between Type I and Type II diabetes a cross-sectiona clinical study was performed in 84 normweight newly diagnosed diabetics with a mean age of 22 years. Taking into consideration clinical and biochemical characteristics of the carbohydrate and fat metabolism, the therapeutic requirement to maintain euglycemic metabolic control, the residual beta-cell function, the HLA phenotype and islet cell antibodies (ICA, ICSA) it could be shown that none of the tested criteria has the ability to distinguish between the types with absolute certainty. As shown by the frequency of the different markers in relation to the therapeutic requirements for euglycemic metabolic control as well as by the correlation analysis between the variables the discriminating validity of the markers decreased in the following sequence: diabetes associated HLA phenotype, residual beta-cell function, proneness to ketosis, age at onset, relative body weight. Neither the characteristics of the carbohydrate and fat metabolism nor the presence of islet cell antibodies contributed much to the differentiation between insulin-dependent and noninsulin-dependent diabetes.

In human sera two methods of islet cell cytoplasmic antibody (ICA) detection (on Bouin-fixed or cryostate sections of human pancreas) and the islet cell surface antibody (ICSA) method on isolated rat islet cells were compared. The ICA detection on Bouin-fixed sections was more sensitive than that on cryostate sections. In two groups of subjects with putative islet cell autoimmunity ICA prevalence was higher than ICSA prevalence. However, a weak correlation between both types of antibodies was established. In one group of healthy subjects with cytotoxic serum against rat beta cells a high prevalence of ICSA was found, whereas none of them had ICA. Defined on the basis of a positive immunofluorescence on rat islet cells, ICSA positive sera of newly diagnosed IDDM patients reacted to a significantly higher percentage with beta cells than did normal controls. In conclusion, of all methods compared ICA detection on Bouin-fixed pancreas sections seems to be the most suitable method for the detection of an islet cell autoimmunity.