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February 15, 2001

Genetics and Heredity

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Question from Walnut Creek, California, USA:

You frequently cite the statistic that there is a 5% chance that a woman with diabetes will have a child with diabetes. However, since no one actually tracks the true number of cases of type 1 diabetes in the United States, and since type 1 is massively under-counted, because those of us who are diagnosed as adults typically are misdiagnosed as type 2 (due to the myth that Type 1 diabetes is a childhood disease), that 5% figure is undoubtedly low.

Answer:

From: DTeam Staff

I would have to agree with you that the 5% figure is an imprecise one, but, equally, I think that you are wrong in saying that this is because type 1 diabetes in adults has been ‘massively underrcounted’. First of all, the figure has held up in parts of the world like Northern Europe and New Zealand where the population is predominantly Caucasian and where the diagnosis of diabetes in younger people has come to be widely confirmed by a positive antibody test. In North America, there is still no figure for Hispanic and African American groups in which the under 20 acute onset group have about a 50% chance of having type 1B or antibody negative diabetes. At the other end of the scale, it has only been in the last few years when antibody testing has become more widely available outside of specific research projects, that the entity of Late-onset Autoimmune Diabetes of Adulthood (LADA) has come to be recognised. In addition, the percentage of people with type 1A (autoimmune) that are ‘late’ is a very small one. The increasing incidence and recognition of type 2 diabetes in young people all over the world will also affect this figure.

In time and when the main subgroups of both type 2 and2 diabetes are more conscientiously defined and have been followed into the child bearing years, there will be more accurate figures Meanwhile, the 5% figure is mainly of value in family planning.

DOB