July 16, 2003
Research: Causes and Prevention
Question from Northboro, Massachusetts, USA:
My six and a half year old daughter was diagnosed with type 1 diabetes about three months ago. She had just gotten over strep throat and finished her antibiotics when she began urinating frequently and drinking gallons of water. Once we were at the hospital and the doctor’ got my daughter’s recent health history, they said it was probably the strep throat that brought on the diabetes and that if she had not had strep throat, she would not have gotten it. The next day, the results of her hemoglobin A1c came back and it was 7.8%, which they said confirmed their suspicions that the strep throat caused her to get diabetes. Could this be true?
The endocrinologist at the hospital said that it was just her unlucky day to get strep throat and that everything going on in her body at the moment she became infected with the strep made her immune system attack her islet cells. What if she got strep throat a month or a year later? Would she have gotten diabetes or would it just have been strep throat — done and over with after a round of antibiotics?
Answer:
There are several forms of diabetes in childhood, but by far the most likely one in a child from a Caucasian family in North America is type 1A (autoimmune) diabetes. This is based on both a genetic predisposition and on environmental factors which are only poorly understood. There is a great deal of scientific evidence however that the immune process which damaged the islet cells in her pancreas had almost certainly been slowly progressing for several years. What the strep throat did was to cause a measure of additional stress which was enough to finally precipitate insulin dependence. It did not cause the diabetes. To confirm this you should talk to the diabetes doctor about getting a full antibody test profile, which would be of some importance in regard to genetic counselling and the long term prognosis.
DOB