I am 21 years old and have had type 1 diabetes for a year. My boyfriend is 26 and has had type 1 diabetes for 13 years. We are afraid for our children. What are the chances that they would acquire the genes and the chance that they express them, meaning the chances that they have type 1 diabetes? What’s proven and what’s not? I have done lots of research and couldn’t find a satisfactory answer. They say it’s less than 20% (or even 9 to 15 %), but what’s less? They also say that the genetic factor is not so important despite that there was a study done on identical twins that shows it is.

The risk for an individual male to have child with type 1 diabetes is in the neighborhood of 3-6%; the risk for a female to have child with type 1 diabetes is in the neighborhood of 2-4%. The risk for both mother and father with type 1 diabetes (your situation) having child with type 1 diabetes is therefore in the neighborhood of 5-15%. This really means that genetic factors are important and having two such genetic factors in both parent is geometrically increased. But, this also means that other, presumably environmental, factors also are important and we do not really understand what these are. There are many theories, including the viral theories, but nothing definitive. If such odds seem too high for the two of you, then you should consider adoption as a good alternative; if it is important to have your own genetic offspring, then one must weigh these risk factors accordingly. Going to see a genetic counselor who can provide the latest research statistics and also provide appropriate counseling should also be considered. Speaking with your own diabetes team may also be very helpful.

SB