[Early diagnosis and prevention of type 1 diabetes: role of the Belgian Diabetes Registry].

The pathological process of type 1 diabetes starts many years prior to clinical diagnosis and is often accompanied by the appearance of circulating autoantibodies directed against islet cell antigens. Once diagnosed, insulin substitution therapy cannot totally prevent the development of chronic complications of hyperglycaemia. Efficient intervention aims at preventing the development of chronic complications. All antibody-positive subjects do not necessarily develop type 1 diabetes and, in case of progression, the destruction kinetics of beta cells may vary from one individual to another. Therefore, it is important to characterise and follow large representative groups of patients and subjects at risk (e.g. first degree relatives of patients with type 1 diabetes) to define selection criteria for subjects with an homogeneous risk of diabetes (and thus of complications) and consider a prevention strategy. The Belgian Diabetes Registry (BDR) has collected epidemiological, clinical and biological data from more than 4000 patients and more than 7000 first degree relatives. The detection of immune, genetic and hormonal markers allows to identify subjects at risk of rapid destruction of residual beta cells in view of their participation in prevention trials.