A. Unfortunately, while it is possible to prevent type 2 or adult onset diabetes mellitus, we don't yet know of a way to prevent type 1 diabetes.
Type 1 diabetes mellitus is also known as juvenile onset or insulin-dependent diabetes mellitus (IDDM). It is an autoimmune disease that damages cells in the pancreas so that they can no longer make insulin.
Genetics of Diabetes
Although type 1 diabetes is a genetic disorder, the way you inherit diabetes is very complex. A person's risk of developing type 1 diabetes is thought to be determined by several genes and unknown environmental factors. Even an identical twin has only a 30 to 50% chance of having type 1 diabetes if his or her twin sibling has it. That risk is only 6 to 10% for fraternal twins.For other siblings, the risk of getting type 1 diabetes is about 5% when another sibling has type 1 diabetes.
Type 1 Diabetes Screening
While it isn't possible to exactly predict who will get type 1 diabetes, it is possible to do tests to see who is at higher risk. This includes:- Testing for islet cell antibodies (ICA)
- Genetic testing for type 1 diabetes
However, genetic testing is likely not yet available outside of these types of clinical trials.
Preventing Type 1 Diabetes
Since there is no cure for type 1 diabetes, an important goal for researchers is to try to prevent kids from getting it in the first place. Although there is no known way to prevent type 1 diabetes yet, current type 1 diabetes prevention clinical trials are looking at:- giving a daily dose of oral insulin or intra-nasal insulin to at risk children.
- giving high risk pregnant women and babies up to five months old DHA (capsules or a baby formula supplemented with DHA) to prevent type 1 diabetes.
- identifying things in the environment that might trigger type 1 diabetes
The Environmental Determinants of Diabetes in the Young (TEDDY) consortium - giving high risk kids Vitamin D supplements.
Preventing Type 2 Diabetes
Unlike type 1 diabetes, it is usually possible to prevent type 2 diabetes by eating healthy, maintaining a healthy body mass index, and promoting weight loss in overweight children.What You Need To Know
- If you have a child with type 1 diabetes, talk with your child's pediatric endocrinologist about the latest guidelines to see what should be done for your other children.
- Even though it isn't possible to prevent type 1 diabetes, knowing if your child is at risk for developing diabetes might make you more watchful for the early development of diabetes symptoms. On the other hand, identifying someone as high risk who will never actually go on to develop diabetes may just raise your and your child's anxiety level as you wait for those symptoms to develop.
Sources:
Type 1 diabetes mellitus: etiology, presentation, and management. Haller MJ - Pediatr Clin North Am - 01-DEC-2005; 52(6): 1553-78
Genetics for targeting disease prevention: diabetes. Primary Care: Clinics in Office Practice - Volume 31, Issue 3 (September 2004)
Clinical review: Type 1 diabetes-associated autoimmunity: natural history, genetic associations, and screening. Barker JM - J Clin Endocrinol Metab - 01-APR-2006; 91(4): 1210-
Specific human leukocyte antigen DQ influence on expression of antiislet autoantibodies and progression to type 1 diabetes. Redondo MJ - J Clin Endocrinol Metab - 01-MAY-2006; 91(5): 1705-13
Prediction of autoantibody positivity and progression to type 1 diabetes: Diabetes Autoimmunity Study in the Young (DAISY). Barker JM - J Clin Endocrinol Metab - 01-AUG-2004; 89(8): 3896-902
Type 1 diabetes: pathogenesis and prevention. Gillespie KM - CMAJ - 18-JUL-2006; 175(2): 165-70
