Permanent diabetes mellitus with onset in the first 180 days of life may be clinically and genetically distinct from diabetes occurring after 180 days.
Most of the early onset cases do not have an autoimmune pathogenesis, according to investigators from multiple Italian institutions including the Second University of Naples in Napoli and the Istituto Superiore di Sanità in Rome.
They studied 111 diabetic patients who received insulin within their first year of life. In this study, 76 percent of patients who experienced diabetes onset within 180 days of birth showed a “protective” human leukocyte antigen (HLA) genotype for type I diabetes mellitus. Only 11.9 percent of the later onset patients had this genotype.
Autoimmunity markers were detected in 15.4 percent of the early onset group compared with 65.0 per cent of the later onset group.
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