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International Handbook of Pancreas Transplantation pp 13–24Cite as

Modern concepts of diabetes and its pathogenesis

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Part of the book series: Developments in Surgery ((DISU,volume 10))

Abstract

Diabetes mellitus affects a large number of individuals and represents a syndrome which is characterized by chronic hyperglycemia. Since blood glucose is controlled by a number of mechanisms, several abnormalities of different etiology and pathogenesis may cause hyperglycemia. The major types of diabetes are non-insulin dependent (Type 2) diabetes (NIDDM) and insulin- dependent (Type 1) diabetes (IDDM). NIDDM can affect as much as 3–4 percent of the population in Western Europe and North America and is probably a heterogeneous disease with multiple etiologies. Obesity is one of the suspected factors. Insulin receptor defects and mutant insulin molecules are etiological factors for only a few IDDM patients. In the majority of patients, onset starts after the age of 40, and about 60–90 percent of the patients are obese. Since most of the problems discussed in this book are less relevant to NIDDM, the modern concepts of diabetes and its pathogenesis that will be discussed in this chapter will refer to insulin-dependent (Type 1) diabetes mellitus (IDDM).

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References

  1. Gorsuch AN, Spencer KM, Lister J, McNally JM, Dean BM, Bottazzo GF, Cudworth AG: The natural history of Type I (insulin-dependent) diabetes mellitus: evidence for a long prediabetic period. Lancet ii: 1363 – 1365, 1981.

    Google Scholar 

  2. Srikanta S, Gunda O, Eisenbarth G, Soeldner JS: Islet cell antibodies and beta cell function in monozygetic triplets and twins initially discordant for Type I diabetes mellitus. N Engl J Med 308: 322 – 325, 1983.

    Article  PubMed  CAS  Google Scholar 

  3. Palmer JP, Asplin CM, Clemons P, Lyen K, Tatpati O, Raghu PK, Paquette TL: Insulin- dependent diabetics before insulin treatment. Science 222: 1337 – 1339, 1983.

    Article  PubMed  CAS  Google Scholar 

  4. Baekkeskov S, Nielsen JH, Marner B, Bilde T, Ludvigsson J, Lernmark A: Autoantibodies in newly diagnosed diabetic children immunoprecipitate specific human pancreatic islet cell protein. Nature 298: 167 – 169, 1982.

    Article  PubMed  CAS  Google Scholar 

  5. Rahier J, Goebbels RM, Henquin JC: Cellular composition of the human diabetic pancreas. Diabetologia 24: 366 – 371, 1983.

    Article  PubMed  CAS  Google Scholar 

  6. Foulis AK, Stewart JA: The pancreas in recent-onset Type 1 (insulin-dependent) diabetes mellitus: insulin content of islets, insulitis and associated changes in the exocrine acinar tissue. Diabetologia 26: 456 – 461, 1984.

    Article  PubMed  CAS  Google Scholar 

  7. Gepts W: Pathologic anatomy of the pancreas in juvenile diabetes mellitus. Diabetes 14: 619 - 633, 1965.

    PubMed  CAS  Google Scholar 

  8. Bottazzo GF, Dean BM, McNally JM, MacKay EH, Swift PGF, Gamble R: In situ characterization of autoimmune phenomena and expression of HLA molecules in the pancreas in diabetic insulitis. N Engl J Med 313: 353 – 360, 1985.

    Article  PubMed  CAS  Google Scholar 

  9. Dobersen MJ, Scharff JE, Ginsberg-Fellner F, Notkins AL: Cytotoxic autoantibodies to beta-cells in the serum of patients with insulin-dependent diabetes mellitus. N Eng J Med 303: 1493 – 1498, 1980.

    Article  CAS  Google Scholar 

  10. Marner B, Lernmark A, Ludvigsson J, MacKay P, Matsuba I, Nerup J, Rabinovitch A: Islet cell antibodies in insulin-dependent (Type 1) diabetic children treated with plasmapheresis. Diabetes Res 2: 231 – 236, 1985.

    PubMed  CAS  Google Scholar 

  11. Lernmark Å: Cell-mediated immunity in Type 1 (insulin-dependent) diabetes: Update 1984. In: Andreani D, di Mario U, Federlin KF, Heding LG (eds) Immunology of Diabetes; pp 121 – 131. Kimpton Medical Publications, London, 1984.

    Google Scholar 

  12. Nerup J, Andersen 00, Bendixen G, Egeberg J, Poulsen JE: Antipancreatic cellular hypersensitivity in diabetes mellitus. Diabetes 20: 424 – 427, 1971.

    PubMed  CAS  Google Scholar 

  13. Maruyama T, Takei I, Matsuba I, Tsuruoka A, Taniyama M, Ideda Y, Kataoka K, Abe M, Matsuki S: Cell-mediated cytotoxic islet cell surface antibodies to human pancreatic beta cells. Diabetologia 26: 30 – 33, 1984.

    Article  PubMed  CAS  Google Scholar 

  14. Mandrup-Poulsen T, Bendtzen K, Nielsen JH, Bendixen G, Nerup J: Cytokines cause functional and structural damage to isolated islets of Langerhans. Allergy 40: 424 – 429, 1985.

    Article  PubMed  CAS  Google Scholar 

  15. Kanatsuna T, Baekkeskov S, Lernmark A, Ludvigsson J: Immunoglobulin from isulin- dependent diabetic children inhibits glucose-induced insulin release. Diabetes 32: 520 – 524, 1983.

    Article  PubMed  CAS  Google Scholar 

  16. Lernmark A, Kanatsuna T, Rubenstein AH, Steiner DF: Detection and possible functional influence ofantibodies directed against the pancreatic islet cell surface. Adv Exp Med Biol 119: 157 – 163, 1979.

    PubMed  CAS  Google Scholar 

  17. Bottazzo GF, Mann JI1, Thorogood M, Baum JD, Doniach D: Autoimmunity in juvenile diabetes and their familes. Br Med J i: 165 – 168, 1978.

    Google Scholar 

  18. MacLaren NK, Riley WJ: Throid, gastric, and adrenal autoimmunities associated with insulin-dependent diabetes mellitus. Diabetes Care 8,1: 1 – 109, 1985.

    Google Scholar 

  19. MacLaren NK, Riley WJ: Throid, gastric, and adrenal autoimmunities associated with insulin-dependent diabetes mellitus. Diabetes Care 8,1: 1 – 109, 1985.

    Google Scholar 

  20. Platz P, Jakobsen BK, Morling M,, Ryder LP, Svejgaard A, Thomsen M, Christy M, Kroman H, Benn J, Nerup J, Green A, Hauge M: HLA-D and DR-antigens in genetic analysis of insulin-dependent diabetes mellitus. Diabetologia 21: 108 – 115, 1981.

    Article  PubMed  CAS  Google Scholar 

  21. Wolf E, Spences KM, Cudworth, AG: The genetic susceptibility to Type 1 (insulin-depend- ent) diabetes: analysis of the HLA-DR association. Diabetologia 24: 224 – 230, 1983.

    Article  PubMed  CAS  Google Scholar 

  22. Owerbach D, Lernmark Å, Platz P, Ryder LP, Rask L, Peterson PA, Ludvigsson J: HLA-D region ß-chain DNA endonuclease fragments differ between HLA-DR identical healthy and insulin-dependent diabetic individuals. Nature 303: 815 – 817, 1983.

    Article  PubMed  CAS  Google Scholar 

  23. Owerbach D, Lernmark A, Rask L, Peterson PA, Platz P, Svejgaard A: Detection of HLA-D/DR-related DNA polymorphism in HLA-D homozygous typing cells. Proc Natl Acad Sci USA 80: 375 – 3761, 1983.

    Article  Google Scholar 

  24. Larhammar D, Schenning HLA, Gustafsson K, Wiman K, Claesson L, Rask L: Complete amino acid sequence of an HLA-DR antigen-like p chain as predicted from the nucleotide sequence: Similarities with immunoglobulins and HLA-A, -B, and -C antigens. Proc Natl Acad Sci USA 79: 3687 – 3691, 1982.

    Article  PubMed  CAS  Google Scholar 

  25. Southern EM: Detection of specific sequences among DNA fragments separated by gel electrophoresis. J Med Biol 98: 503 – 517, 1975.

    CAS  Google Scholar 

  26. Michelsen B, Kastern W, Lernmark Å, Owerbach D: Identification of an HLA-DC ß-chain related genomic sequence associated with insulin-dependent diabetes. Biomed Biochim Acta 44, 1: 33 – 36, 1985.

    PubMed  CAS  Google Scholar 

  27. Michelsen B, Lernmark Å: Molecular cloning of a polymorphic DNA endonuclease fragment associates insulin-dependent diabetes with HLA-DQ. J Clin Invest 79: 1144 – 1152, 1987.

    Article  PubMed  CAS  Google Scholar 

  28. Tager HS: Coupling of peptides to albumin with dinitrofluorobenzene. Anal Biochem 71: 367 – 375, 1976.

    PubMed  CAS  Google Scholar 

  29. Deufel T, Grove A, Kofod H, Lernmark Å: Locus-specific detection of HLA-DQ and -DR antigens by antibodies against synthetic N-terminal octapeptides of the ß-chain. Febs Letters 189, 2: 329 – 337, 1985.

    Article  PubMed  CAS  Google Scholar 

  30. Baekkeskov S: Radiolabelling and immunoprecipitation of islet cell antigens. In: J. Larner and S.L. Pohl (eds.) Methods in diabetes research, vol. I: Laboratory methods, Part A, John Wiley and Sons, New York, pp. 129 – 140, 1984.

    Google Scholar 

  31. Wilkin T, Armitage M, Casey C, Pyke DA, Hoskins PJ, Rodier M, Diaz JL, Leslie RDG: Value of insulin autoantibodies as serum markers for insulin-dependent diabetes mellitus. Lancet 2: 480 – 481, 1985.

    Article  Google Scholar 

  32. Baekkeskov S, Kristensen JK, Srikanta S, Bruining, GJ, Mandrup-Poulsen T, Beaufort C, Soeldner JS, Eisenbarth G, Lindgren F, Lernmark A: Antibodies to a Mr 64000 human islet cell antigen precede the clinical onset of insulin-dependent diabetes. Submitted for publication.

    Google Scholar 

  33. Dyrberg T, Baekkeskov S, Lernmark A: Specific pancreatic 3-cell surface antigens recognized by a xenogenic antiserum. J Cell Biol 94: 472 – 477, 1982.

    Article  PubMed  CAS  Google Scholar 

  34. Baekkeskov S, Lernmark Å: A (3-cell glycoprotein of Mr 40000 is the major immunogen following xenogenic immunization. Diabetologia 27: 70 – 73, 1984.

    Article  PubMed  CAS  Google Scholar 

  35. Hanafusa T, Pujoll-Borrel R, Chlovata L, Russell RCG, Doniach D, Bottazzo GF: Aberrant expression of HLA-Dr antigen on thyrocytes in Graves’ disease: relevance for autoimmunity. Lancet ii: 1111 – 1115, 1983.

    Google Scholar 

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Authors
  1. B. Michelsen
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  2. A. Grove
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  3. H. Vissing
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  4. H. Kofod
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  5. S. Baekkeskov
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  6. M. Christie
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  7. M. S. Pedersen
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  8. Å. Lernmark
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Editor information

Editors and Affiliations

  1. Edouard Herriot Hospital, Dept. of Urology and Transplantation Surgery, University of Lyon, Lyon, France

    J. M. Dubernard

  2. Dept. of Surgery, University of Minnesota, Minneapolis, Minnesota, USA

    D. E. R. Sutherland

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© 1989 Kluwer Academic Publishers

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Michelsen, B. et al. (1989). Modern concepts of diabetes and its pathogenesis. In: Dubernard, J.M., Sutherland, D.E.R. (eds) International Handbook of Pancreas Transplantation. Developments in Surgery, vol 10. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1083-6_2

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  • DOI: https://doi.org/10.1007/978-94-009-1083-6_2

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6977-9

  • Online ISBN: 978-94-009-1083-6

  • eBook Packages: Springer Book Archive

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