Family Diabetes Clues

By Jennifer Abney Anchor

It's unimaginable having more than one child with type 1 diabetes, so imagine a family with three. Family Diabetes Clues

Published: Tue, September 09, 2008 - 4:10 am Last Updated: Tue, September 09, 2008 - 4:34 am

Jennifer Abney

Diabetes is a condition that affects the body’s ability to use glucose, a form of sugar. In healthy people, the pancreas produces a hormone, called insulin, which is used to convert glucose from foods into fuel and get that fuel into the cells. People with type 1 diabetes don’t produce enough insulin. The condition occurs when the immune system inappropriately attacks the insulin-producing islet cells. As more and more islet cells are destroyed, the body loses its ability to get fuel for cells. Even after a meal, when high levels of glucose circulate in the blood, the cells are starved for energy. People with type 1 diabetes need regular injections of insulin to stay alive.

Type 1 diabetes is the less common form of diabetes, accounting for about 5 to 10 percent of all cases. It’s most commonly diagnosed between childhood and early adulthood. The American Diabetes Association estimates about one out of every 400 to 600 children and adolescents in the U.S. have type 1 diabetes.

Over time, diabetes can lead to some serious complications, like heart disease, stroke, blindness, kidney disease, nerve disease, problems with wound healing and amputations. The American Diabetes Association reports diabetes is the fifth leading cause of death in the U.S., killing 224,092 Americans in 2002.

Family History Clues
Family history increases the risk of type 1 diabetes. However, sometimes a diagnosis occurs in a child without any affected family members. William Russell, M.D., Pediatric Endocrinologist with Children's Hospital at Vanderbilt, says, when doctors look more thoroughly at family medical history, though, they’ll often find cases of autoimmune diseases, like hypothyroidism. Since type 1 diabetes is also an autoimmune-type disease, the genetic link is still there.

Doctors don’t know why the body’s immune system attacks its own tissues. Researchers are searching for clues to understand the problem and have initiated the Type 1 Diabetes TrialNet. TrialNet is an umbrella site for several studies seeking to find clues about how type 1 diabetes develops and how the disease may be prevented or treated.

There are two main types of studies in TrialNet. One will look at the natural history of type 1 diabetes to examine potential risk factors for the disease. The second type of study will examine treatments (interventions).

In TrialNet's Natural History Study, participants have yearly blood tests to screen for the autoantibodies (antibodies that attack one’s own body). Russell says patients must lose 40 to 50 percent of their islet cells before symptoms of diabetes appear. Thus, these autoantibodies are present for many years before type 1 diabetes is diagnosed. So far, Russell says scientists have identified four to five autoantibodies that appear to be good predictors for type 1 diabetes.

If the autoantibodies are detected, participants may take place in one of two of the TrialNet's Diabetes Intervention Studies. The first group of studies aims to find new treatments that may delay or prevent the onset of type 1 diabetes. The second group of studies is for people who have been newly diagnosed with the disease. The goal of this research is to find ways to preserve insulin production and hopefully reduce the risk of long-term complications from diabetes.

The Type 1 Diabetes Trial Net is open to two at-risk groups: (1) those 1 to 45 with a first-degree relative (parent, sibling or child) having type 1 diabetes and (2) those 1 to 20 with an affected second-degree relative (aunt, uncle, cousin, niece or nephew). There is no cost for the screening test. For more information, call (800) HALT-DM1. Study sites are located at:

Children’s Hospital Los Angeles, Los Angeles, CA
Stanford University Medical Center, Stanford, CA
University of California, San Francisco, San Francisco, CA
Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, CO
University of Florida, Gainesville, FL
University of Miami School of Medicine, Miami, FL
Riley Hospital for Children, Indiana University, Indianapolis, IN
Joslin Diabetes Center, Children’s Hospital Boston, Boston, MA
University of Minnesota, Minneapolis, MN
Naomi Berrie Diabetes Center, Columbia University, New York, NY
Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA
University of Texas Southwestern Medical Center at Dallas, Dallas, TX
Benaroya Research Institute at Virginia Mason, Seattle, WA

If you would like to participate in the TrialNet studies, call (800) HALT-DM1. Information is also available on the Web at http://www2.diabetestrialnet.org

For general information on diabetes:
American Diabetes Association, http://www.diabetes.org
National Institute of Diabetes and Digestive and Kidney Diseases, http://www.niddk.nih.gov