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Autoimmune type 1 diabetes.

  • Ahmed Delli
  • Helena Larsson
  • Sten Ivarsson
  • Åke Lernmark
  • Richard I. G. Holt
  • Clive S. Cockram
  • Allan Flyvbjerg
  • Barry J. Goldstein
Publishing year: 2010
Language: English
Pages: 141-152
Document type: Book chapter
Publisher: Wiley-Blackwell

Abstract english

The pathophysiologic mechanisms in type 1 diabetes (T1DM) involve loss of islet β-cell secretory function caused by selective killing of these

cells primarily by aggressive autoimmune responses involving both cellular and humoral immune pathways. Inflammatory cells heavily infiltrate pancreatic islets leading to insulitis where CD8+ T lymphocytes are thought to be responsible for selective and specific killing of β-cells.

The complex etiology of T1DM involves a strong genetic predisposition, mainly human leukocyte antigen class II genes, and several putative

environmental factors, which are thought to trigger autoimmunity or progression to clinical T1DM.

A preclinical prodrome in T1DM may vary in duration in which one or more islet autoantibodies may precede insulitis and predict the disease

at the early stages of pathologic insult. In genetically susceptible individuals with islet autoantibodies, metabolic indicators such as insulin release abnormalities and insulin resistance may best predict T1DM especially near clinical onset.

Based on the improving understanding of the etiopathogenesis of T1DM, several clinical trials have been launched aiming at halting the

autoimmunity responses, retarding disease progression or preserving remaining β-cell function after clinical onset.


  • Clinical Medicine
  • Type 1 diabetes
  • autoimmune diabetes
  • insulin-dependent diabetes
  • Islet autoimmunity
  • Islet autoantibodies
  • HLA genes
  • pathogenesis.


  • Diabetes and Celiac Unit
  • Paediatric Endocrinology
  • ISBN: 9781405191814
E-mail: ake [dot] lernmark [at] med [dot] lu [dot] se

Principal investigator

Diabetes and Celiac Unit

+46 40 39 19 01

+46 70 616 47 79


Jan Waldenströms gata 35, Malmö


Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00