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Pancreatic tissue transplanted from a nondiabetic monozygotic twins into the diabetic twin is rapidly destroyed (in absence of immunosuppression) Autoimmune Mechanism: Immune system mediation of pancreatic beta cell obstruction (Type I diabetes) Associated with other autoimmune endocrinopathies adrenal-insufficiency Hashimoto's thyroiditis Most patients have antibodies against insulin and other beta cell antigen Pancreatic beta cell destruction -- development of insulin-dependent diabetes mellitus: slow loss of insulin reserve Prediabetic stages: Islet cell tumor on a development (normal glucose

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Neurology 48, 766773