Rates in families with members who have type diabetes

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A patient with T1DM can have his relatives tested for the HLA complex (see the earlier section "Triggering type 1 diabetes" for more about this complex). The opportunity to do that has led to some valuable insights about T1DM.

1 Only a small fraction (less than 10 percent) of people with the necessary HLA complex develop T1DM.

1 Many relatives of people with T1DM who have the HLA complex develop autoantibodies, like GAD, but never develop diabetes.

i A small percentage (5 to 10 percent) of patients with type 2 diabetes (see Chapter 3) are found to have autoantibodies and are believed to have a slowly progressing form of T1DM called latent autoimmune diabetes in adults (LADA).

These findings indicate that T1DM may be a rapidly progressing disease, it may be a very slowly progressing disease, or it may never occur at all in susceptible individuals. How's that for concrete information?

On the hunt for better names

What's really needed are new names for both T1DM and T2DM that are much more descriptive and clearly separate the two diseases. I believe that referring to them both as types of diabetes suggests that they're extremely similar. It also results in too many instances of confusing studies, where you don't know if the patients were type 1 or type 2 unless it's specified. If you have a suggestion for a name, write me at diabetes [email protected].

When it comes to the importance of a parent's T1DM in predicting whether the child will get T1DM, if the mother has T1DM, there's only a 3 percent chance that the child will develop it. If the father has T1DM, the child has a 6 percent chance of developing it. If both parents have T1DM, the child's likelihood of developing the disease jumps to 30 percent.

How do siblings factor in? Identical twins have a 60 percent chance of both developing T1DM, but the twin who develops it later often doesn't show it for many years. Fraternal twins, who don't share all the same chromosomes, have only an 8 percent chance of both having T1DM, no greater than that of two children born in different years in the same family.

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