This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Does the body's immune system play a role in the development of problems involving the nervous system in people with diabetes?Diabetes is known to be connected with problems involving the eyes, kidneys and nervous system. Little is known about why people develop problems with their nervous system in diabetes. Patients with diabetes report:-Pain-Tingling-Numbness and loss of feeling in their feet and legs.An increased number of antibodies in the blood that can attach to nerve cells and injure the nerve cells have been reported in patients with diabetes. Antibodies are proteins made by your body. The antibodies protect you from infections. Sometimes our body will make antibodies that attach to our own tissues. This type of antibody injures the tissues. These antibodies are called autoantibodies. It is not known why or when these autoantibodies develop in diabetes. We don't know whether these antibodies contribute to the development of complications involving the nervous system. Our study is designed to help answer the following questions:1. When do antibodies begin to appear in people with diabetes? 2. Does the presence of antibodies increase over time?3. Do the antibodies attach to nerve cells?4. If these antibodies attach to nerve cells, what are they specifically attaching to?5. Do these antibodies injure nerve cells?6. If the antibodies cause injury to nerve cells, how does this happen?We hope that answering these questions will lead to better treatments for the nervous system problems associated with diabetes in the future. Type 2 Diabetes is the most common form of diabetes and it affects millions of Americans every year. 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.A total of 120 people 18 years or older will be enrolled into this study. Two groups of people with Type 2 Diabetes and one group of healthy volunteers will be studied. Group 1 will include people with Type 2 Diabetes newly diagnosed and up to 2 years prior to their start in this study. Group 2 will include people with Type 2 Diabetes diagnosed 7 to 9 years prior to their start in this study, and Group 3 will include healthy volunteers. All 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 four to five 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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