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May 25, 2002

Diagnosis and Symptoms

Question from Indiana, USA:

My eight year old daughter hasAutoimmune Polyglandular Syndrome Type II, and one of her physicians has told us she has a high positive GAD antibody with a first phase insulin response of less than 1% (total of first and three minutes was 45) indicating that she has a high risk of developing diabetes. Can you tell me the percent of risk she has for developing diabetes? How long (in years) until this happens in years?

Answer:

While a good question, the answer isn’t fully known. The Denver group has published data in this area. I would think months rather than years from what I understand. It seems you have a very good endocrinologist who had really done a great job with your child. I would ask him/her.

LD
Additional comments from Dr. Donough O’Brien:

In one sense your daughter already has autoimmune diabetes with a diagnosis of the Autoimmune Polyglandular Syndrome Type II, a positive anti-GAD test and a first phase insulin release of less than 1 %. Using the latter quotient only, the mean time to the development of clinical or insulin dependent diabetes is a little over 18 months with about an 80% chance of the appearance of clinical diabetes within three years. This estimate is likely to be shortened if high titers of ICA 512 and insulin antibodies were also present, and, of course, if there was to be any intercurrent infection. I know of no estimates of additional bias from the various components of APS Type II.

DOB

[Editor’s comment: Of course, estimates of how long it might take to develop clinical diabetes are general statements, and should not be specifically applied to any single individual case.

WWQ]