[Autoimmune phenomena in diabetes mellitus. On the pathogenetic and diagnostic significance]

The detection of islet cell antibodies lead to an increasing interest in autoimmune mechanisms in Typ I diabetes mellitus. Other phenomena such as insulitis in juvenile diabetics and in experimental animals, cellular immune reactions and concomitant antibodies against other endocrine organs, antinuclear antibodies and circulating immune complexes supported these suggestions. HLA-association and viral infections could be predisposing and inducing factors, although there are no clear correlations to any viral infection in a larger number of patients so far. For clinical and therapeutic purposes there are not enough sufficient criteria to demonstrate a pathologic autoimmune process in patients before developing diabetes. Up to now there is no realistic possibility and justification for starting an early immunosuppressive therapy.