Autoimmune Diabetes

Question 1

DM1 incidence decreasing of increasing?

Answer 1

increasing

Question 2

Antibodies play a role in DM1?

Answer 2

Not really, antibodies can’t be within cell.

Question 3

What is level of autoantibodies in preclinical DM1?

Answer 3

increased for years before overt diabetes

Question 4

risk of DM1 if had one islet with autoantibodies? when is risk higher?

Answer 4

low (12.7%)

Two or three increases to 80%

Question 5

median age at seroconversion for DM1?

Answer 5

2.1 years

Question 6

Adults get DM1?

Answer 6

Yes. Latent autoimmune diabetes

Question 7

Is DM1 acute process with full islet destruction?

Answer 7

Nope, takes years, patchy process of destruction

Question 8

B-Islets killed by CD4 or 8?

Answer 8

CD8 via perforin and granzyme B

Question 9

What is APS-1 syndrome? How does it happen?

Answer 9

Autoimmune polyglandular syndrome

Mutations in AIRE gene

Question 10

What is IPEX? Immune Dysfunction polyendocrinopathy enteropathy, X-linked? how does it affect DM1

Answer 10

FoxP3 gene mutation controlling Tregs

80% of kids with it develop DM1?

Question 11

T-cells recognise which part of insulin?

Answer 11

C-peptide

Question 12

do identical twins both have DM1? what does it mean?

Answer 12

only 30-40% get it if other twin is positive: environmental factors are important in autoimmunity

Question 13

What’s wrong with current DM1 Rx?

Answer 13

can’t mimick physiology
risk of hypoglycaemia
burdensome

Question 14

Advantage of islet transplantation?

Answer 14

glycemic control, so less hypoglycaemia unawareness

Question 15

problems with islet transplantation?

Answer 15

need immunosuppressants, cost, longevity viability

Question 16

‘holy grail’ of DM1 treatment?

Answer 16

Antigen specific tolerance