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November 23, 2002

Research: Causes and Prevention

Question from Factoryville, Pennsylvania, USA:

My daughter was diagnosed with type 1 diabetes last year, and since we have no family history of it (only type 2), I cannot, for the life of me, figure out how my daughter got this disease. I have recently found that there are quite a number of people I run into who tell me that either their son or daughter or grandchildren also have type 1 diabetes, so it seems there are far too many children getting this disease. At least five out of every 10 people I talk to know a child with type 1 diabetes. Why are all of these kids getting this? Is this vaccine related? I think someone needs to do a study to find out the true numbers of children getting this. This is more than average. Something is going on here.

Answer:

Your daughter almost certainly has type 1A (autoimmune) diabetes, the incidence of which seems to be very slowly increasing all over the world. One of the best of a number of recent studies was reported from Oxford in England just a few months ago. This particular form of diabetes arises as a result of both an inherited susceptibility and an environmental trigger that initiates insulin dependence. Since the inherited component doesn’t change the increase is presumed to be due to the environmental factors which so far have been only poorly delineated. Early exposure to cow’s milk has been a strong contender, but the evidence is controversial. A few viral infections such as those with Coxsackie B have some role, and, in some parts of the world, so does lack of vitamin D. One small group in the USA. have long proposed a link with various immunisations, but their conclusions have been rejected by the Communicable Disease Center in Atlanta as well as most vigorously by the New Zealand Government where some of the work took place. Better definition of these environmental factors is indeed being vigorously pursued and has turned up some odd bits of information such as the protective role of intestinal threadworms.

The inheritance of type 1A diabetes is recessive, which is to say that the relevant genes must be inherited from both the mother and the father neither of whom would show evidence of the condition themselves and probably not in their families either. This is why nearly all people with new onset type 1A diabetes have no family history.

What may have confused the impressions you received is that type 2 diabetes in children has strikingly increased in many parts of the world in the last few years due to a lifestyle change which dismisses vigorous physical exercise and favours high fat, high carbohydrate ‘fast food’ style meals.

DOB