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August 4, 2007

Research: Causes and Prevention

Question from Indianapolis, Indiana, USA:

We have a son with type 1 diabetes. Recently, our four-year-old daughter tested positive for GAD and MIAA auto-antibodies through a TrialNet study. She has no symptoms at all of diabetes. Does this mean her body is already attacking her beta cells? Will she most likely get diabetes? We are having a glucose tolerance test in two weeks and will be doing Phase 2 of the study. We have been given information on Phase 3 of the trial, oral insulin versus placebo. From everything I have seen on the net, it looked like the oral insulin DPT-1 failed, but the literature that the doctor gave me seems to suggest that there is evidence that the oral insulin helped delay onset and reduce insulin requirements. I wanted to put her in the trial (if she qualifies), but not if it has already proven to make no difference. What have you heard about it? I really just want some more opinions.

Answer:

A positive antibody test indicates increased risk. You should then have more specific genetic studies to see if the genes she has are the same, similar and how similar, to your other child. This also helps to stratify risks. What happens with the more specific testing would be important and what happens over time to these titers will also be important. You should go back to the research team and ask these detailed questions to help you decide if she should participate, what the risks are and what odds are currently known for success or failure. Currently, our research belief is that we maybe able to postpone, but not totally stop, diabetes. Newer medications may be better, but with more unknown short- and long-term side effects/risks.

SB