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The frequency of diabetes in children of type 1 diabetic parents
I Rjasanowski1, L Vogt, D Michaelis
1Clinic for Diabetes and Metabolic Diseases Karlsburg, Germany.
Insights
Children of parents with Type 1 diabetes have a lower than expected risk of developing the disease. However, a significant percentage of non-diabetic offspring show early signs of subclinical diabetes.
Area of Science:
- Endocrinology
- Genetics
- Pediatrics
Background:
- Limited data exists on Type 1 diabetes (T1D) risk in offspring of affected parents.
- Understanding genetic and environmental factors is crucial for T1D risk assessment.
Purpose of the Study:
- To determine the actual incidence of T1D in children born to Type 1 diabetic parents.
- To investigate the prevalence of subclinical diabetes markers in non-diabetic offspring.
Main Methods:
- Follow-up study of 48 children (born 1955-1989) from 35 Type 1 diabetic families.
- Health status assessed via hospital records and interviews; included oral glucose tolerance tests, insulin secretion, autoantibodies, and HLA-typing.
- Data collected up to June 1992.
Main Results:
- Type 1 diabetes developed in 19 out of 48 offspring (39.6%).
- The disease onset in children was significantly earlier than in their parents (8.2 vs. 15.9 years).
- Among 21 non-diabetic offspring, 5 (24%) exhibited impaired glucose tolerance, reduced first-phase insulin secretion, and/or Islet Cell Antibodies.
Conclusions:
- The observed T1D incidence in offspring was lower than anticipated.
- A notable proportion of non-diabetic children from T1D families show subclinical diabetes indicators.
- Further research is needed to understand the long-term implications of these findings for diabetes prevention.
Abstract:
There is little information in the literature about the actual diabetes risk of children of Type 1 diabetic parents. In a follow-up study of 48 children born from 35 Type 1 diabetic parents between 1955 and 1989, we have recorded all data relating to the incidence of Type 1 diabetes and of appearance of signs of subclinical diabetes by June, 1992. Information about the state of health was obtained during repeated stays of the patients in our hospital or by interviewing them by letter. In 21 children aged between 4 and 29 years who had not developed diabetes, we were able to investigate oral glucose tolerance, first phase insulin secretion, islet cell antibodies and insulin autoantibodies. HLA-typing was performed in 69 of the 118 study subjects (children and their parents). Type 1 diabetes developed in 19 out of 48 offspring of Type 1 diabetic parents. Frequency is also 25% in those 24 offspring born before 1972. The children developed the disease significantly earlier than the parents (8.2 +/- 6.0 versus 15.9 +/- 8.3, p < 0.01). Diabetes became manifest in 4 single children, in 2 HLA-identical pairs of siblings, and in 4 children with non-diabetic siblings. In 5 out of 21 non-diabetic offspring investigated we found impaired glucose tolerance, diminished first-phase insulin secretion, and/or Islet Cell Antibodies between 5 and 80 JDF units. The frequency of diabetes in the offsprings of Type 1 diabetic parents was lower than expected, but in addition 24% of the non-diabetic children displayed signs of subclinical diabetes.