How, When, and Why to Predict IDDM

Insulin-dependent diabetes remains a serious disease replete with life-threatening complications. The onset of the disease is becoming increasingly predictable through the detection of its associated autoantibodies. The natural history of pathogenic events is attenuated in those with adult onset over that seen in infants and children. Immunosuppression therapies in newly diagnosed patients have been shown to induce remissions, whereas various intervention strategies in rodent models (BB rats and nonobese diabetic mice) can delay and even prevent the onset of diabetes. The stage is set for serious consideration of intervention trials to delay the clinical disease in humans.