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Genetic, Acquired, and Related Factors in the Etiology of Diabetes Mellitus
Om P. Ganda, MD;
Stuart S. Soeldner, MD
Arch Intern Med. 1977;137(4):461-469.
Abstract
Diabetes mellitus is not a single disease entity, but a heterogenous group of disorders with a striking diversity of etiopathogenetic mechanisms as well as clinical manifestations. Lack of a known genetic marker for the disease(s) and variable influences of environmental factors on the expression of a putative diabetic genome have resulted in considerable debate over its etiology.
Over the past few years, systematic epidemiologic studies, along with knowledge gained from a close association of certain human-leukocyte-antigens with the diabetic diathesis and possible role of host-immune factors, and gene-virus interaction have led to considerable advancement in the understanding of the disease-complex.
Pending the availability of definite genetic marker(s), we propose a new, tentative classification based on the etiologic mechanisms. We also suggest that the term "prediabetes" be abandoned as a prospective entity, since as presently employed, this connotation carries a risk probability no different than the terms like prehypertension or precoronary thrombosis.
(Arch Intern Med 137:461-469, 1977)
Author Affiliations
From the E. P. Joslin Research Laboratory, Department of Medicine, Peter Bent Brigham Hospital, Harvard Medical School; and the Joslin Clinic and New England Deaconess Hospital, Boston.
Footnotes
Reprint requests to 170 Pilgrim Rd, Boston 02215 (Dr. Ganda).
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