[Prediction of type I diabetes by antibody screening]

For the prediction of type I diabetes in first degree relatives of type I diabetics, a variety of laboratory methods are now available. Thus, screening for serum antibodies against the body's own insulin, islet cells and the enzyme glutamate decarboxylase, represents a simple and well-established routine examination used for early diagnosis. The combination of various parameters such as e.g. the age of the person at risk, antibody status (nature, number, combination or titer of the antibodies) and capacity for early insulin secretion following i.v. glucose loading, permits us to predict, with quite good accuracy, the risk years before there are any clinical manifestations. These successes of early diagnosis have led to new concepts of immunoprophylaxis for the prevention of type I diabetes. Thus, at the present time two highly promising studies involving the prophylactic administration of insulin or nicotinamide in persons at risk are underway in Germany, the results of which to date suggest that a new epoch of immunotherapeutic treatment of this disease may be in the offering.