It has been suggested that diabetes in Black (B) children & adolescents is more diverse in its etiology & pathogenesis than in young Whites (W). We have demonstrated a recent significant rise in incidence of IDDM in B adolescents in a population-based registry. We evaluated ICA, both on human(H) & rat (R) pancreas, antibodies to GAD65 & to ICA512 (IA-2) in 316 children < 19 yrs of age (284 W, mean age 8±4.5 yrs; & 32 B, mean age 10±4.9 yrs) in blood drawn within 3 months of diagnosis with IDDM, consecutively during 1983-1985, 1989 & 1996 in Children's Hospital of Pittsburgh. They were divided into 4 groups according to race & age. Table

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B adolescents (≥ 11 yrs) showed a lower prevalence of almost all antibodies compared to the other 3 groups, with ICA (R) being the only exception. When comparing the prevalence of antibodies in the 2 adolescent groups, ICA (H), GAD & IA-2 were significantly lower in the B than W. Also, the prevalence of at least 2 & 3 antibodies was also consistently lower in the adolescent B when compared to the other 3 groups. These results suggest that 20% of B adolescents with a diagnosis of IDDM in whom we have demonstrated a significant rise in incidence, may have a non-autoimmune type of diabetes or may present with antibodies not being detected by these traditional assays.