My elder daughter, age 11, has had type 1 for seven years. My second daughter, who is six, was just diagnosed with type 1 this week. We did the antibodies test one year ago and the results were negative so we were not concerned. Now, I am not sure what happened to cause her diagnosis. There is no family history of type 1. Do my wife and I carry the genes that are the reason our children are getting diabetes?

This is a great question, but nobody can really answer such a question since we do not have sufficient research information for an answer. Clearly, there is a genetic component with risks for first degree relatives, about 2 to 5%. Antibody results are nonspecific and only positive about 60 to 80% of the time depending upon which laboratory is utilized, how good the assay used is and whether one, two, three or four antibody levels are checked. Most specific would include islet cell antibodies, research level insulin antibodies before any insulin is given and IA2 antibodies as well as GAD-65 antibodies. Other autoimmune disorders also help determine relative risks (i.e., thyroid antibodies, hypothyroidism, hyperthyroidism, celiac disease, Addison’s adrenal insufficiency, pernicious anemia). Your diabetes team could review your family history and provide more detailed genetic information and counseling rather than such generalities.

SB