July 22, 2003
Diagnosis and Symptoms, Research: Causes and Prevention
Question from Littleton, Colorado, USA:
My 13 year old, who was in the DPT-1 clinical trial from age 7-12, was ICA positive at the beginning, but during the five year period, she did not have any other positive antibodies. Since she is no longer in the study, I feel very anxious about not knowing her health status. Her pediatrician doesn’t seem concerned and has not ordered any follow up tests. She has a physical coming up soon, and I feel the doctor should be watching her more closely, but I have no idea what tests should be done.
For the last several weeks, my daughter has been either chewing or sucking on ice a lot. She just tells me that it tastes good, but I’m concerned that she may have increased thirst and not realize it. She also does not know that she is at increased risk and is ICA positive. I told her she was in the study because her two cousins have diabetes, and we are just being careful. I am afraid to tell her she is at higher risk because of the stress it will put on her.to have to worry about a disease she may never get since she is a worrier. Am I doing the right thing?
If the only indication of diabetes that your daughter has had during five years in the DPT-1 trial is a positive initial islet cell antibody test, I think you can assume that her risk of developing type 1A (autoimmune) diabetes now is much nearer to that of the normal population than that incurred by having two affected cousins. I think that the pediatrician was right to treat her as essentially normal and not to repeat any of the antibody tests again, especially as you say that she is made anxious by this emphasis on a disorder she is unlikely to suffer from.
In any case as you probably know, neither subcutaneous insulin as in the DPT-1 trial nor nicotinamide as used in ENDIT (the corresponding European/Canadian trial) showed any effect on the incidence of autoimmune diabetes.