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Correspondence
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Volume 342:1835-1837 June 15, 2000 Number 24
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A Novel Subtype of Type 1 Diabetes Mellitus

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 by Imagawa, A.
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To the Editor: Imagawa and colleagues (Feb. 3 issue)1 provide evidence that an acute insult to the exocrine pancreas, possibly caused by a virus, may trigger type 1 diabetes mellitus. In a subgroup of adult Japanese patients presenting with type 1 diabetes, they found T-lymphocyte infiltration in the exocrine pancreas but no circulating antibodies to islet-cell antigens characteristic of autoimmune diabetes. These patients had an acute onset of hyperglycemia and normal glycosylated hemoglobin values, suggesting that the loss of beta cells was rapid and occurred before the onset of antibody production. However, the authors found no clinical or laboratory evidence . . . [Full Text of this Article]

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