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Question:

From Thomasville, North Carolina, USA:

I do not have diabetes but my boyfriend does. Other people in my family and in his have diabetes. He has type 1 diabetes, diagnosed when he was 12. He is 18 and will turn 19 in October 2011. My question is, because he's type 1 diabetic and I am not, when we have children, will our children have diabetes when they are born? Are there tests that doctors can do to test unborn babies for diabetes? Also, are there medications that doctors can administer during pregnancy to prevent the baby from getting diabetes? When my boyfriend's mother was pregnant, her doctors were treating her with some kind of medication to keep the baby from getting diabetes and she lost the baby. We don't feel comfortable asking her about the drugs they were giving her or why she thought she lost the baby.

Answer:

It is extremely rare for a baby to have diabetes "when they are born." While this can occur, it is not at all common.

Might a child the two of you have develop diabetes mellitus later in life? Yes, they might. Type 2 diabetes is the more common type of diabetes that is more often associated with lifestyles of poor eating habits, inactivity, and obesity. Type 2 diabetes more often occurs in adults but, unfortunately, because of the epidemic of childhood obesity, we are seeing this more in children and teens and young adults, too. Type 2 diabetes can run in families but is, by-and-large, avoidable with good attention to staying trim, active, eating a balanced diet, etc. Type 2 diabetes may not necessarily require insulin injections.

Type 1 diabetes, the type your boyfriend is said to have, can also be inherited. But, type 1 diabetes requires insulin injections in order to stay alive! Type 1 diabetes is associated with some specific configurations of the genes in the DNA. Type 1 diabetes is most often diagnosed in childhood (middle school [like age 12 - as with your boyfriend] and early elementary school years) but can develop and any age, but not so often after age 40 years (of course that's the time type 2 diabetes can develop if one is heavy and inactive). If one has the genetic profile and propensity, it does NOT mean one WILL develop type 1 diabetes, but does certainly increase the likelihood.

(To help explain that, I like to use an example that you are probably familiar with: smoking is associated with lung cancer. Smoking increases the risk of lung cancer significantly. But, just because you smoke doesn't mean you will develop lung cancer. And, of course, there are people who smoke who, luckily, don't develop lung cancer. But, if you WANT to develop lung cancer, then smoking is the highway to get there! So,going back to diabetes, there are people who do not have the genetic risk profile who develop type 1 diabetes anyway; maybe 5% of the time. But, if you do have that special higher-risk profile, the risk increases by about 10 fold !)

There ARE special genetic tests that can be run on the baby at birth (and some perhaps even before birth) to see if the infant is at risk because he or she carries the higher risk genes. Again, just because the gene risk is there, it does NOT mean the infant WILL develop type 1 diabetes sometime in their life. There are special research programs that have looked to track and even consider methods to control this for infants discovered shortly after birth. One such research program is called PANDA. Some major medical centers are on the cutting edge of this research and would be a wonderful source of information for you. You might consider contacting the pediatric diabetes research group at the University of Florida in Gainesville for more information. The link above can help.

I will add that one of the higher risk factors for a child to develop type 1 diabetes mellitus in their life is for the child's father to have type 1 diabetes.

Your question certainly centers around the infant having diabetes at birth. Again, this is so rare. I wonder if there has been some misunderstanding or miscommunication regarding your boyfriend's mother receiving a medication to prevent the unborn fetus from developing diabetes. For example, there can be immediate health problems for a fetus or newborn born to a mother with uncontrolled diabetes during her pregnancy or at the time of delivery, but the infant doesn't have diabetes in this situation.

While it might be difficult for your boyfriend's mother to discuss, it would be extremely helpful for your own family planning to better understand what happened with the fetus she lost. I think that if you ask gently and respectfully and politely, explaining your concerns for your own future family, she would open up to you and her son.

You will also probably benefit by reading our web pages, What is Type 1 diabetes? and Type 2 Diabetes.

DS

DTQ-20110414125924
Original posting 20 Apr 2011
Posted to Genetics and Heredity and Other

  
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Last Updated: Wednesday April 20, 2011 09:43:48
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