Type I Diabetes as a 'Mendelian' and 'Regulated' Immune Process

From studies of non-organ specific autoimmune diseases such as Lupus Erythematosus the concept has developed that autoimmunity is characterized by marked variation over time reflected by clinical remission and exacerbation. Our family studies of the development of Type I diabetes is providing us with a very different picture of the autoimmunity associated with Type I diabetes. In addition studies of NOD mice indicate that the Mendelian inheritance of a series of necessary but not sufficient diabetes associated alleles (H-2 NOD, theta linked, and the autosomal recessive gene determining anti-polar antibodies) create diabetes susceptibility. We will review our studies indicating that Type I diabetes is an autoimmune process in which there is remarkable quantitative stability of autoantibody levels amongst prediabetics (at times extending to more than a decade).