Autoimmune Diabetes Mellitus

Autoimmune diabetes mellitus is a chronic disease caused by the immune destruction of pancreatic beta cells. Under its classical presentation, this type of diabetes tends to cause chronic hyperglycemia, and exogenous insulin is required to survive and prevent ketosis. In genetically predisposed individuals, possibly triggered by non-well-identified factors, there is primarily a cellular (through autoreactive T cells) destruction of pancreatic beta cells. Specific biochemical assayed autoantibodies (anti-GAD65, anti-insulin, anti-IA-2, and anti-ZnT8) are the essential markers used for diagnosis. Treatment consists of daily administration of exogenous insulin under self-monitoring conditions of glucose levels. Maintenance of optimal glucose control is essential to reduce lifelong microvascular complications. Very recently, teplizumab, the first treatment with the potential to modify the course of the disease, has been approved.