ur in early adolescence. This form of t
we comes on slowly and with
the stim cess
ronmental event occurring sev
eral years before the cell mass has been re-
duced sufficiently for the person to develop
the symptoms. These children often have a the
fairly good partial remission period after diag opo
nosis and carly treatment. The course of this in
type of diabetes is usually milder than that
for others. These children do have a high fre-
quency of other autoimmune diseases such as ke
hypothyroidism. hypoadrenalism, pernicious t
anemia, alopecia areata, vitiligo, and other dis
cases of the thyro-gastric complex.
The second form of the disease occurs an
mainly in younger patients, usually under an
school age. This form of the disease comes on ic
much more quickly than
the one mentioned ic
above and can often be associated with a pre T
ceding viral infection. These children usually
lose all or nearly all of their B cells quickly
and seldom have much of a remission period.
They usually do not have other autoimmune
diseases.
The third form of the disease is now called
latent autoimmune diabetes meyitus, This
form of the disease occurs in adults and is sim-
ilar to the first form of the disease described
present
above. Pancreatic antibodies are
forms of
these patients as they are in the onset ma
he disease describe above but the not occur until late in adulthood. This form
of TIDM is differentiated from T2DM by the
presence and persistence of pancreatic au
toantibodies, especially one called glutamic
acid decarboxylase (GAD), which is a good
predictor as well of future TIDM. Latent au-
toimmune diabetes mellitus has sometimes
been referred to as type 1 'n diabetes. T2DM
patients who are severely insulin depleted and
present with diabetic ketoacidosis are aiso
sometimes referred to as Type 1 2 diabetes
patients.
of TIDM, the com
In all of these forms mon denominator is damage and death of the
is of the pancreas by immune system s
lymphocytes, with loss of insulin produc
tion. The insulin deficiency thus produced is
absolute and lifetime. Absolute insulin defi.