Saturday, 8 August 2009

The aetiology of Type 1 diabetes mellitus

Studies from Seattle confirm denervation of the islets of Langerhans in T1DM. The authors wondered how the "autoimmune " process in T1DM results in loss of islets and their nerves as well ?

Original criteria for autoimmunity included an antigen, autoantibodies and reproduction of the histopathology by injecting the antigen into an animal species (Witebsky's postulates, 1957). In T1DM we have no antigen, some autoantibodies, CD4 and CD8 lymphocytes in the pancreas, and, some HLA associations. Adjacent evidence - but circumstantial. What if primary denervation were the primary source ? (Quinn, Am J Med, 2008)

If autonomic denervation is responsible, then what causes it ? In adult women pelvic denervation arises from childbirth (prolonged second stages) and persistent, physical efforts during defaecation. In supine infants coeliac denervation may result from similar bowel problems associatd with weaning. Finnish mothers have low rates of exclusive breastfeeding, high rates of cows-milk allergy, high rates of infant bowel disorders and the highest rates of T1DM worldwide. A full account follows shortly.

3 comments:

  1. Amazing article this was. Risk factors that may initiate the autoimmune process include early exposure to proteins from cow's milk, nitrosamines or early fetal events, such as blood group incompatibility of the fetus or viral infections.

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  2. Treatment of type 1 DM requires a multidisciplinary approach by a physician, nurse and dietitian. In patients with new-onset type 1 diabetes you should begin insulin therapy for life. And chronic disease, DM requires long-term medical care.



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  3. Treatment of type 1 DM requires a multidisciplinary approach by a physician, nurse and dietitian. In patients with new-onset type 1 diabetes you should begin insulin therapy for life. And chronic disease, DM requires long-term medical care.I know that these patients are to be treated with more care.

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