Abstract
Serial changes in the prevalence of islet cell antibodies (ICA) and ICA titers over the ten years follwing diagnosis were studied in 34 children with insulin-dependent diabetes mellitus (IDDM), 17 with abrupt onset and 17 with slow onset, whose duration of disease was more than five years.
There was a high prevalence of ICA in both forms of IDDM at the time of diagnosis (abrupt onset 94%, slow onset 82%). However, the decline in the frequency of ICA in slow onset patients was less marked than that in abrupt onset patients after a duration of one year om more (47 vs 82%; 1-3 years, 24 vs 47%; 3-5 years, 24 vs 47%; 5-7 years, 18 vs 53%; 7-10 years, p<0.05). Concerning the changes in ICA titer, abrupt onset patients initially had high ICA levels (160-320 Juvenile Diabetes Foundaton; JDF units), but ICA titers decreased rapidly with time. On the other hand, soiw onset patients tended to show low ICA titers for a long period after diagnosis (20-40 JDF units).
From these results, it is possible that the change in ICA titer reflects the slow autoimmune destruction of pancreatic β-cells and slow onset IDDM is characterized by relatively mild progression in the early phase of the disease.