Perspectives in Diabetes Prediction and Prevention of IDDM-1991

Although we can now identify some nondiabetic suggest that prolonged and possibly permanent remissions individuals who will subsequently develop clinical in the IDDM disease process are as common as progressive insulin-dependent diabetes'melliius (IDDM), our ability P-cell loss leading to clinical DDM. to predict subsequent clinical IDDM is far from perfect. The Barts-Windsor family study probably provided the first In this article, we discuss the status of knowledge evidence that the IDDM disease process is not always proregarding the natural history of preclinical IDDM and gressive. During the initial 5 yr of follow-up, over half of the discuss, especially in relation to Predicting IDDM1 the nondiabetic first-degree relatives of IDDM children who had genetic, immunologic, and metabolic components of initially been positive for complement-fixing lCAs became the IDDM disease ProcessDiabetes 40:943-47, 19g1 negative without developing IDDM (2). Although this obser-