Enzyme-linked immunosorbent assay (ELISA) was applied for detection of human islet cell surface antibodies (ICSA) to rat islet target cells. In 23 healthy controls without hereditary diabetes the findings were on the upper normal limit (mean value of optical density + 3 SEM). The results above the limit were considered positive. 11 out of 18 insulin-dependent (Type I) diabetics with the disease duration less than 5 years were ICSA-positive. All 9 patients with insulin-independent (Type 2) diabetes were ICSA-negative. 3 out of 18 healthy subjects (siblings and children of probands with type II diabetes) were strongly ICSA-positive, although all the members of this risk group had unimpaired oral glucose tolerance test. Thus, ELISA screening of ICSA may be useful for discriminating patients with different types of diabetes and revealing nonaffected individuals at high risk according to their beta-cell integrity.

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