Closing in on Type 1 Diabetes

In this issue of the Journal, Martin et al.1 present a striking report of a boy with X-linked agammaglobulinemia in whom typical type 1 insulin-dependent diabetes mellitus developed at the age of 14 years. This report is of great interest because it shows that type 1 diabetes can develop in the complete absence of B cells and autoantibodies. This is convincing evidence that B cells are not required for the development of this disease and that the principal effector mechanisms are mediated by T cells.Martin et al. showed that the patient's cultured T cells proliferated in response to two . . .