From New Jersey, USA:
At age 12 3/4, our child, a Caucasian male, 5'7" and 135 pounds, was diagnosed with type 1 diabetes. He was healthy, and asymptomatic, until six weeks prior to diagnosis. At that point, he was in a traumatic car accident (the car was totaled; impact was in his quadrant of the car -- while he suffered only minor physical injuries, he hit his head on the roof of the car, jammed his knees into the front dashboard, and was traumatized, crying in fear/pain for about 30 minutes until his door was pried open and he was removed from the car).
During the next six weeks, he became tired easily and was also very thirsty. We took him for a routine physical at this point, when sugar was found in his urine, and he was ultimately diagnosed with type 1 diabetes (physicals prior to the accident were negative with respect to sugar in his urine; in addition, he was a happy child, excellent in his studies, and a good athlete. There were no major negative stresses in his life, except for the trauma of this accident).
We have read in several sources that while the predisposition to get type 1 diabetes is largely genetic, the incident that triggers onset of diabetes can be environmental. Published sources indicate that the trauma of a severe automobile accident can trigger type 1 diabetes. Do you concur?
You are correct in supposing that the initiation of the clinical phase of autoimmune or Type 1A diabetes depends on both genetic and environmental factors. In your son's case it is almost certain that the autoimmune process of beta cell destruction started several months and even years before the accident. For most of this period there would be no hyperglycemia or glucosuria because until the insulin producing capacity of the pancreas has been reduced below 90% or more there is a sufficiency of insulin to meet daily needs.
The actual clinical phase can be precipitated by any stress. An immunisation reaction or an infection are common examples; but usually there is a closer association in time between the stress and the onset of clinical diabetes. In your son's case it would be possible to argue that the accident hastened the clinical onset by a few days or weeks; but not that it 'caused' the diabetes.
In the next few months, the most important thing from your son's point of view will be to master the skills of good blood sugar control and to help him to deal with the accident so that it is not a source of continuing stress.
Original posting 8 Oct 1998
Posted to Diagnosis and Symptoms
Last Updated: Tuesday April 06, 2010 15:09:00
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