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October 25, 2001

Research: Causes and Prevention

Question from New Zealand:

My 30 year old husband has just been diagnosed with type 1 diabetes, and since there is absolutely no family history -- how did he get it? He was (until about six weeks ago) really fit and healthy, and this has just come completely out of the blue.

Answer:

The most probable explanation is that your husband has one form of Late-onset Autoimmune Diabetes of Adulthood (LADA). In this case at least two of his antibody tests (anti-GAD, anti-ICA512, and anti-insulin) should have been clearly positive.

If he was overweight and not inclined to exercise, he might have been one of the minority of people with type 2 who present with acute insulin dependence, but are antibody negative. Finally, he might he have one those cases of LADA in which the autoimmune component is less emphatic.

The distinction is of some importance because the last two categories may in a short time be able to be managed with diet, exercise, and perhaps, oral hypoglycemic agents instead of insulin. All three conditions have a genetic basis, and in the case of LADA there is a so far undefined environmental component. It is in fact he same disorder as type 1A (autoimmune) diabetes in children, but one in which the destruction of insulin producing cells progresses over many more years and does not develop clinically until more than 90% of the cells are destroyed.

DOB