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February 5, 1982

Diabetes Mellitus: A Disease That Is Coming Into Focus

JAMA. 1982;247(5):590-594. doi:10.1001/jama.1982.03320300016015

Advances in Diabetes Research  In recent years, there has been an enormous amount of progress in understanding and treating diabetes. Just a few years ago everyone thought of diabetes as a single disease. It is clear now that diabetes is a heterogeneous group of disorders, almost all of which have a genetic basis, but in which the genetic types vary. Not only does the insulin-dependent (juvenile onset) form of diabetes differ from non-insulin-dependent (maturity onset) diabetes, but even within each of these two types there appears to be heterogeneity.

Genetics and Environment  We know that insulin-dependent diabetes, for example, is associated with certain genetically determined histocompatibility antigens. The environment appears to determine whether this form of diabetes will be expressed clinically in the genetically susceptible individual.Non-insulin-dependent diabetes so far has not been associated with particular HLA antigens. Nevertheless, genetic factors clearly cause or contribute to this form of diabetes.