26.7 Path: Type 1 DM

Question 1

What is detectable in serum years prior to being diagnosed with Type 1 DM?

Answer 1

Autoantibodies (seroconversion)

Question 2

What is marker of endogenous insulin production?

Answer 2

C-peptide

Question 3

In high risk children, what was the median age for seroconversion and then development of diabetes?

Answer 3

Seroconversion: 2.1 years
Diabetes: 3.5 years later

Question 4

What are some genetic mutations that can result in development of diabetes?

(2)

Answer 4

APS-1 Syndrome: AIRE mutation

IPEX: FoxP3 mutations

Question 5

What is AIRE important for?

Answer 5

Tolerance of peripheral antigens in the thymus

Question 6

What proportion of people with an IPEX (FoxP3 mutation) develop diabetes?

What is FoxP3 important for?

Answer 6

80%

Regulatory T-cells

Question 7

What is proinsulin?

Answer 7

The precursor of insulin and C-peptide

Question 8

What happens to the need for insulin with islet allotransplantation?

Answer 8

Eventually no exogenous insulin needed (or excellent glycaemic control if independence is not achieved)