Insulin-Dependent Diabetes Mellitus and Autoimmunity: Islet-Cell Autoantibodies, Insulin Autoantibodies, and Beta-Cell Failure

Abstract
To the Editor: In February 1983 the Journal published our report of islet-cell autoantibodies and beta-cell function in monozygotic triplets (19.11 and 16.11[b]) and a monozygotic twin (18.12) initially discordant for insulin-dependent diabetes mellitus (IDDM).1 This report showed (1) the detection in genetically susceptible persons of circulating islet-cell antibodies (reacting with undefined islet-cell antigens on pancreatic sections) before the apparently "acute" clinical onset of IDDM, (2) a slowly progressive reduction in beta-cell function (the early-phase insulin response to intravenous glucose) during the "prediabetic phase" of this disease, and (3) relatively normal indexes of glucose homeostasis (such as fasting blood . . .