I read your response to the mother who inquired about her two children out of three who were diagnosed within weeks with Type 1 Diabetes.
In 1969 two of my three children were diagnosed within twelve hours. The youngest was 4 at the time, male. I had taken him for a "well" check. A routine urinalysis was done. It showed sugar so I was asked to bring in another sample in later that day. It was the same. He was hospitalized. Being taught the signs, I was sure my oldest, then 6, was diabetic as well. Our pediatrician was highly doubtful. We had no diabetes history in the family to our knowledge. Yet she, too, checked out the same.
During a 1981 consultation with a specialist in Dallas, my daughter was told that environmental factors have much to do in diabetes. He was sure that this brother and sister were a prime case. Unfortunately, my daughter died in 1983 from unknown cause. My son is now 31 and doing very well on NPH and Regular insulin.
The original ideas on the role of environment came from studies by Dr. David Pyke at King's College Hospital in London on the discordance for diabetes in identical twins. There were other striking examples, for instance Cook islanders get very little Type 1 Diabetes in Raratonga; but if they emigrate to Auckland their incidence then approaches that of Caucasian New Zealanders. Early exposure to cow's milk has for a number of years been thought to be a factor as has smoked mutton in Iceland.
Recently the environmental role has become more difficult to interpret. Two large studies set up to look into this, DAISY in the U.S. and BABY-DIAB in Germany increasingly emphasize the role of genetics. If this is so, then it is important because it makes genetic markers much better determinants of who is likely to get Type 1 Diabetes. Someday soon I hope we can reconcile these opposing viewpoints.
Original posting 9 Jul 97
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