This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The causes of long-term complications associated with type 2 diabetes mellitus are poorly understood. Previous studies suggest that patients with type 2 diabetes can develop autoimmune immunoglobulins (autoantibodies directed against their own tissues) during the course of their illness. We will examine the hypothesis that a significant percentage of patients with type 2 diabetes will slowly develop autoantibodies during the course of their illness and that these autoantibodies contribute to the injury and loss of cells in the nervous system, a well-known complication in long-term diabetic patients. Two groups of type 2 diabetic patients will be enrolled in this study. Group 1 will have the diabetes for three to four years at the time of enrollment. Group 2 will have had diabetes for seven to eight years at the time of enrollment. Both groups will undergo a thorough examination of their nervous system function and have blood drawn to screen for the presence of autoantibodies. All participants will undergo re-evaluation between three to four years after the initial testing. These studies will help to determine the significance of autoimmune mechanisms in the natural history of nerve injury that occurs in type 2 diabetes mellitus
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