Since mumps virus seems to be one of the most likely candidates in viral etiology of insulin-dependent diabetes (IDDM) we studied the possible relationship of glucose tolerance (75 g oGTT), beta cell function, diabetes associated HLA antigens, haptoglobin phenotype, islet cell antibodies (ICA) and islet cell surface antibodies (ICSA) in 125 subjects with antecedent mumps infection. Impaired glucose tolerance (IGT) was diagnosed in 3.2% (n = 4) but onset of diabetes did not appear within 14 months after mumps infection. There was no relationship between glucose tolerance and complications of antecedent mumps infection (e.g. pancreatitis, meningitis, orchitis). The prevalence rate of ICA was 76%. ICSA were detectable in about 36% of children and 62% of the adults tested (p less than 0.01). There was no relationship between ICA/ICSA and diabetes-associated HLA antigens, haptoglobin phenotype or beta cell function (fasting C-peptide and insulin response to 75 g oGTT). However, adults with circulating ICA were characterized by a significantly lower insulin response to glucose. Fifty two "risk" subjects characterized by IGT, diabetes associated HLA antigen(s), ICA or ICSA either alone or combined were studied again 26 months after mumps infection. No symptomatic diabetes appeared and IGT was diagnosed in one case only. ICA and ICSA persisted in more than 50% of subjects in whom ICA or ICSA were present 14 months after mumps infection. Since the used immunological techniques do not clearly distinguish organ-specific from non-organ-specific antibodies the results must be interpreted with caution. To summarize, the preliminary results do not support a close temporal relationship between mumps infection and the onset of IDDM. The pathogenetic role of mumps virus and ICA/ICSA and their possible relation to a slow progressive beta cell destruction has still to be determined.

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The possible relationship between genetically determined haptoglobin phenotype and insulin-dependent diabetes (IDDM), circulating insulin antibodies and the occurrence of microangiopathy was studied in 144 IDDM. There were no differences regarding the distribution of Hp-phenotypes in 144 patients in comparison with a control population (n = 1726). Irrespective of the Hp-phenotype, the degree and severity of diabetic complications (retinopathy and/or nephropathy) significantly increased with the duration of diabetes. There was no relationship between Hp-phenotype and diabetic microangiopathy (retinopathy, nephropathy). No association existed between Hp-phenotype and the percentage of insulin antibody binding. Regardless of the Hp-phenotype, the insulin antibody concentration decreased with increasing duration of diabetes. Insulin binding parameters (maximum binding capacity and equilibrium dissociation constant) were found to vary considerably with the Hp-phenotypes among IDDM. For a given duration of diabetes the equilibrium dissociation constant increased significantly in the range from Hp 1-1, Hp 2-1 to Hp 2-2 phenotype. There was a direct relationship between the logarithm of the equilibrium dissociation constant and the degree of metabolic control, i.e. the lower the dissociation constant the better the metabolic balance. In conclusion, the results do not provide support for a putative relationship between Hp-phenotype and IDDM. However, differences between insulin binding parameters, in dependence on the Hp-phenotype may be of clinical importance.