Inhibition of Glucose Transport by Immunoglobulins in Type I Diabetes Mellitus

To the Editor: The article by Johnson et al. (March 8 issue)* on the inhibition by immunoglobulins of glucose transport into islet cells suggests another possible mechanism for the destruction of islet cells — namely, intracellular hypoglycemia. If beta-cell insulin production is directly linked to intracellular glucose levels, then cellular hypoglycemia secondary to inhibition of glucose transport into the beta cells could lead to decreased insulin production and consequently systemic hyperglycemia, This hyperglycemia might initially ameliorate the intracellular hypoglycemia by a mass-action effect in any beta cells still viable. Eventually, progression of the pathologic process could lead to intracellular…