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June 30, 2004

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Question from Everett, Massachussetts, USA:

Why do I have diabetes if NO one in my family has it?

Answer:

From: DTeam Staff

Yes, why does ANYONE develop diabetes? This is a question that should have been addressed, and probably was discussed, by your own diabetes management team with you and your parents.

The usual cause of type 1 diabetes is a process whereby your own immune system (those processes of the body that help you fight infections, deal with allergies, and help prevent you from contracting illnesses for which you had your baby shots/immunizations) produces proteins (called “antibodies”) which “attack” the pancreas and interfere with the ability to manufacture insulin.

When your own immune system begins to “attack” and inflame yourself and specific organs, this is called an “autoimmune” process. Autoimmune processes leading to illnesses in people are actually rather common. Other examples include conditions of the thyroid gland in your neck, rheumatoid arthritis of the joints, specific types of anemia requiring injections of Vitamin B12, vitiligo (a skin condition whereby the coloring of the skin fades leading to rather stark white patches), celiac disease (an intestinal disorder whereby there is poor ability to digest certain grains such as wheat and barley), and even a very serious, broader disorder called “lupus” whereby many different organs and blood vessels are inflamed.

We do not know what causes this “overactivity” of the immune system, but it does tend to run in families. High blood pressure or breast cancer may be more common in some families, but we do not know how to predict who will get them. They are not typically autoimmune diseases, however. So, while there may not be anyone known to you in your family to have diabetes (at least not now), it would not be a surprise to learn that someone has another type of autoimmune disease such as one of the ones listed above. For example, thyroid disease is so very common and so easy to treat, that any relative with it might simply be treated and not made a big declaration to anyone else in the family sharing the information. Certainly, sometimes we do not find other family members with known autoimmune diseases.

Your diabetes team can perform simple blood tests on you to see if you have these various, common pancreas autoantibodies.

There certainly are less common forms of type 1 diabetes that are not associated with autoimmune antibodies. Some forms are related to previous illnesses or medicines or drugs that, on rare occasions, injure the pancreas.

You should feel comfortable in knowing about your own body. So, you should feel comfortable asking your own doctor ANY question about your health and the medicines/treatments that you receive.

Type 2 diabetes is NOT due to an autoimmune process. It is due more often to a degree of inefficient action of insulin. It typically occurs in older or overweight people. We are seeing more type 2 diabetes in young people. You indicated you had type 1 diabetes.

DS