Proposed guidelines on screening for risk of type 1 diabetes.

Abstract

These guidelines represent the recommendations of the Immunology of Diabetes Society (IDS) on the assessment of risk of type 1 diabetes in unaffected first-degree relatives of patients with the disease, and are based on the consensus reached at a symposium held at the fourth meeting of the IDS (Fiuggi, Italy, November 1999). Assessment of risk of type 1 diabetes in relatives was initially based on detection of circulating islet cell antibodies (ICAs) supplemented by measurement of insulin autoantibodies (IAAs), and evaluation of β-cell function by determination of the first-phase insulin response (FPIR) in the intravenous glucose tolerance test. Other islet autoantigens, including GAD and the protein tyrosine phosphatase IA-2/ICA512, have subsequently been identified, and the role of autoantibodies to these antigens in assessment of risk of type 1 diabetes in first-degree relatives has been investigated in a number of large prospective studies. In addition, the genetic susceptibility to type 1 diabetes, particularly that conferred by genes in the HLA class II region, has been …