IMMUNOLOGICAL ASPECTS OF DIABETES MELLITUS IN CHILDREN

Abstract

Diabetes mellitus is a metabolic disease characterized by hyperglycemia. It is caused by deficiency of insulin secretion, insulin action or both and results in abnormal metabolism of carbohydrate, protein and fat. It is the most common endocrine­ metabolic disorder of childhood and adolescence.

Diabetes mellitus arises by several mechanisms. In insulin­ dependent diabetes mellitus (IDDM or type I diabetes), the natural history and associated autoimmune phenomena suggest a systemic disorder that affects the function of the endocrine pancreas. Most patients developing the disease have autoantibodies reactive with islet -cells e.g. circulating cytoplasmic islet cell antibodies (ICA), insulin autoantibodies (IAA) and islet cell surface antibodies (ICSA), the presence of inflammatory cells in diabetic pancreas suggest a cell mediated immune reaction. An immunogenetic background of IDDM was evident from the association with HLA markers on chromosome 6.

The era of prevention of type I diabetes in many studies is by using immunosuppressive drugs. In non-insulin dependent diabetes mellitus (NIDDM or type II diabetes) is thought to be a syndrome of altered insulin action and secretion. This work aims to review the immunological changes in diabetic children and its application in therapy and prevention of the disease.