Etiology of fulminant type 1 diabetes

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We have clarified the etiology of fulminant type 1 diabetes, a novel subtype of type 1 diabetes, from the aspects of epidermiology, genetics, histology, virology and immunology.Epidemiological analysis of 161 patients of fulminant type 1 diabetes has revealed frequent flu-like symptoms (71.7%) and abdominal symptoms (72.5%) before the onset of the disease (Diabetes Care 2003).HLA analysis has shown that DR4 is predominant in fulminant type 1 diabetes but DR9 is not. DR2 was not resistant to fulminant type 1 diabetes (submitted). Genetic analysis has further revealed DRB1*0405-DQB1*0401 is predominant in fulminant type 1 diabetes (in preparation).By the examination of pancreatic biopsy specimens of fulminant type 1 diabetic patients, not only beta cells but also alpha cells were destructed, suggesting a molecular mechanism destroying both beta and alpha cells (in preparation).We have also identified the elevation of enterovirus antibodies in the serum of recent-onset fulminant type 1 diabetic patients (in preparation) and the activation of beta cell reactive Th1 T cells by using Elispot assay in those patients (in preparation).