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June 6, 2005

Diagnosis and Symptoms, Genetics and Heredity

Question from North Carolina, USA:

I was diagnosed with gestational diabetes in late 2001 with my first pregnancy. My doctor told me that after I delivered, it would take about four to eight weeks for my blood sugars to return to normal. They did not and, in late 2003, I was admitted to the hospital with an A1C of 12.0. We found out about two weeks later that I was pregnant again. I delivered my second child in April of 2004 and am now a type 2 diabetic. Could I have adult onset of type 1 instead of type 2? I am only 27. Doesn't type 2 happen to older people? And, what are the chances of one of my sons developing type 1 diabetes? Type 2 diabetes runs on both sides of my family as well as my husband's.


Your question is a good one. In general, it is: do you have type 1 or type 2 diabetes? Your family history and history of gestational diabetes point to a diagnosis of type 2 diabetes. There are additional markers that help to make the diagnosis of type 1 diabetes. Points in favor of type 1 diabetes include low C-peptide levels in response to an oral glucose load, absolute insulin dependence, and positive antibody markers in the blood.

If you have type 2 diabetes, your children have roughly a 50% risk of inheriting the disease. This does not absolutely equal 50% chance of having the disease as there is also an element of environment (activity, weight, etc) that also determines whether blood sugars rise with genetic risk. Notice that the numbers for type 2 diabetes are higher in offspring than for type 1 diabetes where they are 10% or less, depending on which parent has type 1 diabetes. Interestingly, the risk is greater if the father has type 1 diabetes.