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September 9, 1999

Research: Causes and Prevention

Question from California, USA:

My son, age 3.5 years, was diagnosed with Type 1 diabetes when he was 1 year old. He suffered a very serious bout of croup 10 months prior which required extensive hospitalization. There is a history of diabetes in my family as my maternal aunt has Type 1. Specifically, I believe that although he was predisposed to diabetes, the croup sped up the onset of the diabetes. It appears as though the research may support this. How will this event cycle affect my son?

Answer:

I assume that your son does indeed have Type 1A (autoimmune) diabetes as shown by a positive antibody test. If this is indeed the case, then he was genetically predisposed to this type of diabetes and the process of autoimmune damage to the insulin producing cells had probably started early in the first year of life. You are also right in supposing that the croup would have speeded up the process and hastened the onset of clinical diabetes. The episode of croup itself is unlikely to affect the long term problem of the diabetes where it is good control of blood sugars that matters most, albeit in a 3 year old not to the point of increasing hypoglycemia.

I ask about the antibody test because sometimes the child is antibody negative and has a different disorder that has come to be called Type 1B diabetes. The fundamental cause of this is not yet understood and it is unlikely that the effect of the croup would have been any different; but a significant number of these children are able to come off insulin in the first year after the onset at least for a number of years.

DOB