Immunogenetic Aspects of Adult Onset IDDM in Korea

Abstract

Insulin-dependent diabetes mellitus (IDDM) is a clinical diabetes of severe insulin deficiency, resulting from a slowly progressing autoimmune destruction process of pancreatic beta cell. Noninsulin-dependent diabetes mellitus (NIDDM) is a less severe form of diabetes of unknown etiology, although insulin resistance is suspected as the prime abnormality. This distinction is sometimes difficult as there is no clear transition point to apply.¹ Certain HLA class II molecules, particularly DR3 or DR4, have been known to be associated with IDDM susceptibility.² With the recent advances of molecular biology, the presence of DNA sequences coding for non-aspartic acid in the 57th position of the DQ beta chain and arginine in the 52nd position of the DQ alpha chain are known to be highly associated with IDDM in Caucasians.^3,4 The associations of HLA alleles with IDDM, but not with NIDDM, was taken as an evidence that IDDM and NIDDM are two distinctively different diseases. Recently, however, several investigators suggest that HLA might also play a role in NIDDM.^5–8