From California, USA:
My daughter was diagnosed two years ago at the age of 13 with type 1. My father and my grandmother both have type 2, my niece also has type 1 with no history of type 1 in the family. How did these girls end up with type 1?
The incidence of Type 1A or autoimmune diabetes in Caucasian children in the U.S. is about 18 per 100,000 per year up to age 18. There is an environmental component that has to supplement the genetic one for the immunological and clinical features to develop, and only about 5% of the children with affected first degree relatives get the disorder. With these sort of figures it is not surprising that in most new onset cases there is no family history. The underlying genetics and pathology of Type 2 diabetes is quite different and it is also a much more common problem especially as age increases, so that the occurrence of Type 2 also in your family is almost certainly statistical happenstance.
Occasionally diabetes is seen in childhood that is not Type 1A and the antibody test is negative. Most of these children need insulin to start with; but often it can be discontinued and they can then be managed in the same way as Type 2 diabetes. In some of them there is a chromosomal abnormality and it is possible, albeit very remotely so, that every one in the family has the same diabetes problem. To explore this possibility would be tiresome and expensive and would not contribute anything to management. One day perhaps the facilities for more precise definitions of the underlying mechanisms of diabetes will become readily available.
Original posting 24 Aug 1998
Posted to Genetics and Heredity
Last Updated: Tuesday April 06, 2010 15:08:58
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