The discovery of islet cell antibodies (ICAs) led to reconsideration regarding the role of autoimmune processes in induction of diabetes mellitus.

Insulin-dependent diabetes mellitus results from the autoimmune destruction of the insulin producing b-cells of the pancreatic islets. Immunohistochemical examinations of the pancreas biopsy specimens revealed signs of active autoimmune phenomena, e.g., lymphocytic infiltration or immunoglobulin deposition in islets.

The aim of this study was to find out whether ICAs (by a standard indirect immunofluorescence technique) could be used to identify subjects at risk for type I diabetes.

In the present prospective diabetes family study, 23 of 2.642 first-degree relatives of patients with type I diabetes have developed the disease. The antibody status of these 23 samples was compared with that from 23 carefully matched control. At a mean of 2,6 years before the onset of diabetes, ICAs were found in 16 patients (versus 0 control subjects, p<0.001). The authors consider that ICAs may be interpreted as an immunological change in the islets of first-degree relatives of patients with type I diabetes.