Prediabetes: genetic, immunological and metabolical aspects

There is mounting evidence from experimental animal diabetes and from human epidemiological studies that a long period of "prediabetes" precedes the clinical onset of type 1 (Insulin Dependent) Diabetes Mellitus. In this review, the authors evaluate the main informations concerning the genetic, immunological and metabolic aspects of this phase of prediabetes and the relationship of prediabetes with the onset of the disease. Prediabetes is a long period; in this period the destruction of beta cells can be caused by many factors and by many pathogenetic mechanisms. Nowadays, we begin to understand some of these mechanisms and the central role of the activation of the immune system; this activation results in various humoral and cellular abnormalities detectable in the prediabetic phase. These abnormalities, together with metabolic ones, have been reported in many studies. Consequently, we have at our disposal some genetic, immunological and metabolical markers which can be useful in the detection of the person at risk of developing diabetes mellitus.