Early stages of diabetes mellitus in first-degree relatives of insulin-dependent and non-insulin-dependent diabetics.

This work deals with preclinical stages of diabetes mellitus in 494 first-degree relatives of insulin-dependent and non-insulin-dependent diabetics: 182 parents and 66 siblings of diabetic children, 176 offspring of diabetic mothers and in 70 offspring of both non-insulin-dependent diabetic parents. In these persons the family history, oral glucose tolerance test and insulin secretion were studied, blood levels of lipids and fibrinogen were investigated, neurological examination was performed, the neurocirculatory deviations and changes on the fundus were observed and HLA antigens were typed in comparison with the control groups. Long-term follow-up proved, that offspring of both non-insulin-dependent diabetic parents are the most homogenous group. Fluctuating development of abnormalities of glucose tolerance during a long period from a relative early age of 30-40 years with primary insulin resistance, compensatory hyperinsulinism and its delayed secretion and later with relative insulin deficiency are characteristic. Such development is associated with an increase body weight and of blood pressure and often with elevated lipid and fibrinogen levels.