Diabetes as autoimmune disease - Diabetes type I

Type 1 diabetes mellitus (T1D), also known as insulin dependent diabetes mellitus, is a chronic immune mediated disease that is characterized by selective loss of insulin producing β cells of the pancreatic islets in genetically susceptible subjects . The majority (95%) of cases are attributable to an autoimmune-mediated destruction of β cells (type 1a) while a small minority (5%) of cases results from an idiopathic destruction or failure of β cells (type 1b) (1) . T1D is observed in approximately 5-10% of diabetes mellitus patient . It may be present at any age and with equal affection of both sexes . It appears most typically in early life with a peak around the puberty, but one-fourth of cases are diagnosed in adults . T1D remains the most common form of diabetes in childhood, accounting for approximately two-thirds of new diagnoses of diabetes in patients ≤19 years of age in the United States, despite the increasing rate of type 2 diabetes . The incidence of T1D varies 50100 fold around the world, with the highest rates in northern Europe, with 57 .4 cases/100 .000 per year in Finland and with relatively low incidence of 0 .6/100 .000 in China (2) . The incidence of childhood T1D is rising rapidly in all population, especially in the age under 5 years, that suggests a strong environmental contribution . Lately, through several studies, there are strong efforts to understand and explain pathogenesis and find the new therapeutic options of the disease according to potential auto-antigens (insulin) and different environmental factors, as an important key in the development of T1D . But the role of specific factors such as viruses or ingested food (milk) remains controversial (3,4) . Diagnosis of clinical manifested T1D is based traditionally on diabetes mellitus typical clinical symptoms: polyuria, increased thirst, weight loss, weakness, hunger, recurrent infection and in severe insulinopenia the patient are prone to diabetic ketoacidosis . Important diagnostic parameters are also for T1D characteristic HLA gene and especially different autoantibodies against antigens of β cells, which could be present several years before clinical manifestation of disease .