Type 1 @entity6 is a @entity66 caused by an interplay of poorly known environmental factors and partially characterized genetic factors. Focal infiltration of the endocrine pancreas by mononuclear cells and a strikingly decreased functional beta cell mass constitute the histopathological hallmarks of the disease at diagnosis, but there is a marked interindividual variability in terms of the extent of the lesions. The disease process is triggered long before clinical onset as testified by the appearance of circulating islet cell autoantibodies years before the development of @entity4854 . After diagnosis the current insulin substitution therapy is unable to completely avoid the occurrence of the chronic complications of @entity4854 . The design of effective prevention of @entity4854 in subjects at risk or of a lasting cure in @entity1 intends to eradicate the development of the invalidating chronic complications. Such clinical studies are complicated by the existence of large interindividual differences in the progression of beta cell destruction, both before and after diagnosis. Therefore it is important to first biologically characterize larger representative groups of @entity1 and subjects at increased risk (e.g. first degree relatives), and to follow them up clinically in order to establish objective criteria for the selection of study subjects with a more homogeneous risk of beta cell destruction for participation in clinical prevention studies. In Belgium a national collaborative program--the Belgian @entity6 Registry--has allowed to collect epidemiological, clinical and biological data in more than 3,500 @entity1 and more than 6,000 relatives. The detection of islet cell-specific autoantibodies--if possible complemented with genetic and hormonal markers--facilitates the identification of subjects at high risk of rapid beta cell destruction. For example, in first degree relatives the combined presence of @entity9217 antibodies and the HLA-DQ2/DQ8 genotype defines a small group of subjects (< 1%) with 75% risk of @entity6 within 5 years. They qualify for participation in intervention studies aiming at beta cell mass preservation. These findings have helped to prepare several prevention studies in Belgium.

[Preventative biology of type 1 XXXX : implications for clinical preventative studies].

@entity1 :: ('9606', 'Species') :: ['patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['multifactorial disease'] @entity6 :: ('MESH:D003920', 'Disease') :: ['Diabetes', 'diabetes'] @entity9217 :: ('5798', 'Gene') :: ['IA-2'] @entity4854 :: ('MESH:D006943', 'Disease') :: ['hyperglycemia']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes']
