Type 1 Diabetes Clinical Trial
Evaluate the autoantibodies, such as glutamic acid decarboxylase (GAD65), tyrosine phosphatase (IA-2 or ICA125), islet autoantibodies (IAA) and other associated autoimmune autoantibodies: microsomal antibodies, thyroglobulin antibodies, gastric parietal cell antibodies in patients with type 1 DM.
Type 1 diabetes mellitus (DM) is a common disease in pediatric endocrine clinic and
epidemiological studies showed the racial variation in the incidence, with the highest of 35
cases per 100000 in Finland. The incidence of type 1 DM in Taiwan is reported to be 1.5 per
100000 for the population less than 30 years old. While the diagnosis is made, the residual
islet cell function is only about 20% of normal population. Therefore, the principle therapy
in these patients is insulin therapy lifelong.
The pathogenesis of type 1 diabetes mellitus is multifactorial and controversial, involving
the genetic and environmental factors. Type 1 DM is an autoimmune disease, which is T cell
mediated islet cell destruction. Ninety percent of patients with type 1 DM express at least
one of the autoantibodies to the islet. Antibodies to glutamic acid decarboxylase 65 (GAD65)
were observed in 60-80% of such patients, which were considered the most important
autoantigens. The autoantibodies disappeared successively after diagnosis and decreased in
concentrations over time, but titers of antibodies to GAD65 had been observed fluctuated in
patients with type 1 DM.
The prevalence of GAD antibodies, insulin autoantibodies, IA-2 (tyrosine phosphatase) were
reported as 45-67%, 23-67% and 49%, respectively in Taiwan. Other associated autoimmune
disease, such as autoimmune thyroiditis were reported as 13-24%. Such differences may be
caused by the enrolling criteria and different age population. Therefore, we want to
elucidate the role of autoantibodies in the pathogenesis of type 1 DM.
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Observational Model: Defined Population, Time Perspective: Longitudinal
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