Natural History of Autoimmune Diabetes and Its Complications

Background:

• Diabetes is a disease defined by abnormally high blood sugar (glucose) levels. Glucose is an essential source of energy for the body s cells, but insulin is required to move the glucose into the cells. Insulin is a hormone produced by the pancreas that allows glucose to enter cells.
• In diabetes, the body is unable to supply enough insulin to meet its demands. The problem may be a low supply of insulin or a high demand for insulin. Someone who has been diagnosed with diabetes has lost much of their insulin-producing capacity. Clinical studies have shown that good control of blood sugar is essential to prevent diabetes complications like damage to the eyes, kidneys, nerves, and blood vessels.

Objectives:

• To establish a relationship with several individuals with diabetes caused by the immune system attacking the body s insulin-producing cells in order to:
• Explore why the immune system attacks insulin-producing cells.
• Understand why some individuals develop diabetes-related complications and others do not.
• Develop therapies to improve how patients can control their blood sugar levels.
• Continue to follow subjects who have completed or are considering other NIH diabetes-related studies.
• To develop improved tests for determining an individual s risk for developing diabetes and/or to accurately diagnose the exact type of diabetes.

Eligibility:

• Individuals who have been diagnosed with or are at risk for developing diabetes.

Design:

• Standard physical examination and clinical tests to determine if the patient has diabetes or to confirm a particular type of diabetes:
• None of the treatment in this study is experimental.
• Patients will receive a separate consent form for any special tests needed to learn more about their particular type of diabetes.
• Patients may be asked to provide additional urine and blood samples for use in laboratory research about diabetes.
• Researchers may offer medical treatment advice for diabetes, or explain how to improve patients diabetes management skills.