**4. T1D sybtype may be responsible for the T1D territorial heterogenity in Ukraine**

Currently, researchers (eg. Dib & Gomes, 2009) distinguish such subtypes of T1D, as T1A (characterized by selective destruction of beta-cells by an autoimmune process that quickly leads to absolute insulin deficiency; most common among caucasians), LADA (Latent Autoimmune Diabetes in Adults with an onset usually after 35 years of age and characterized by slowly developing insulin deficit), and T1B, also called idiopathic (clinical course is similar to T1A, but without the autoimmune component). Fulminant diabetes is one of the subtypes of T1B. Its is common in asian countries, such as Japan, China, and Korea. It is characterized by a very quick progression of acute metabolic decompensation, damage of alpha and beta cells of pancreas, and absence of autoimmune disorders. The discovered positive relationship between T1D prevalence, exogenic insulin requirement level, development of diabetes complications, and mortality does not allow us to associate T1D territorial heterogenity with LADA. Furthermore, the increase of GADA persistence in T1D patients who reside in regions with higher prevalence of this disease does not allow to consider T1B as responsible for this phenomenon. Thus, T1A rather than T1B subtype of T1D determines the territorial differences in the risk of developing T1D as well as course severity of this autoimmune disease.
