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November 14, 2001

Research: Causes and Prevention

Question from San Juan, Texas, USA:

My two and a half year old little boy was perfectly fine until out of nowhere he was suddenly was diagnosed with type 1 diabetes. What causes a two and a half year old child to get type 1 diabetes? How true is it that he could have gotten his liver bruised or hurt and his liver went into shock? Is it that the pancreas that got hurt and went into shock?

Answer:

I know how shocked and worried you are about your precious little one. I hope that my answer is comforting to you.

Despite our perception that type�1 diabetes comes like a bolt of the blue, that is really not true. The usual cause of type 1 diabetes is due to a process in which the body’s immune system begins to produce proteins (antibodies) that slowly “attack” the pancreas and interfere with insulin production. This has essentially nothing to do with liver or pancreas injury. In many ways, it is similar to how your body makes protein antibodies to fight measles, after you have had a vaccination.

Why do people develop these self-destructive antibodies (also called “auto-antibodies”)? We don’t know exactly, but we do know that there is a strong genetic link with other types of autoimmune diseases such as thyroid problems, lupus , rheumatoid arthritis, vitamin B12 deficiency, vitiligo, and others. Why someone in the family has thyroid problems while someone else is fine (today) and someone else develops type 1 diabetes is what is not clear.

However, the immune inflammation of the pancreas is not sudden. Many studies have estimated that the immune proteins are generally present for at least six months (and sometimes for years), potentially injuring the pancreas, before true diabetes develops. It is estimated that nearly 95% of the insulin-producing abilities of the pancreas must be gone before the sugar values rise, but we can’t 100% predict who will develop diabetes. However, now that your child has diabetes, other family members might be able to be screened, including testing for these pancreatic antibodies.

Please try to relay your fears, worries, and anger to your child’s diabetes team. They’ve been there and can help guide you through this uncertain time for you. They may be able to set you up with a parent support type of a network.

DS