Combined measures of prediction

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The synthesis of all the factors that contribute to an outcome of Type 1 diabetes, into a formula would be the combined measures of prediction. This has yet to be done and remains a complex problem, which has led to “models” of disease pathogenesis, but these have yet to be tested or placed in the framework of prediction. The production of autoantibodies and measures of beta cell failure are phenotypic measures of both genetic and environmental mandates. Combination of multiple autoantibodies and evidence of failing glucose homeostasis provides the highest measure of risk currently possible, and predicts impending diabetes. However, to assign a risk prior to autoantibody production, requires investigation of multiple parameters including gene-gene as well as gene-environment interactions. An understanding of these combinations is elusive but attempts and newer technologies continue to reveal the layers of regulation and genetic interactions contained within the human genome. The most rapid change in human recorded history has occurred in the last century, particularly within the environment and includes changes to our co-habiting micro-flora as well as events on a much larger scale. These areas of investigation promise to provide the power to improve prediction of disease and provide insight into intervention, but have yet to deliver