http://pubs.jamanetwork.com/ en-us Wed, 19 Jun 2013 00:00:00 GMT Tue, 18 Jun 2013 20:44:36 GMT Silverchair editor@pubs.jamanetwork.com webmaster@pubs.jamanetwork.com http://pubs.jamanetwork.com/article.aspx?articleID=1697946 Wed, 19 Jun 2013 00:00:00 GMT Skyler JS, Sosenko JM. <span class="paragraphSection">Type 1 diabetes (T1D) occurs in individuals with a genetic predisposition to the disease, predominantly from a human leukocyte antigen (HLA)-related immunogenotype that accounts for approximately 60% of the genetic influence. In these individuals who are genetically at risk, an environmental trigger is thought to initiate an immune response targeting the insulin-secreting pancreatic islet β cells. The initial immune response also may engender secondary and tertiary immune responses that contribute to the impairment of β-cell function and destruction of β cells. The rate of development of T1D varies, probably related to non-HLA genetic factors and additional environmental factors beyond the triggering exposure.</span> 309 23 2491 2492 10.1001/jama.2013.6286 http://pubs.jamanetwork.com/article.aspx?articleID=1697946