The risk of developing type 1 diabetes – can it be predicted

What you need to know in order to determine the risk of developing type 1 diabetes? Can a disease manifest be predicted?

Type 1 diabetes is 7-9 times less than type 2 diabetes , but it usually progresses faster. Since type 1 diabetes manifests more often in childhood, it is also called “young diabetes.” Unlike non-insulin-dependent diabetes, the development of type 1 diabetes most often occurs suddenly, sharply and quickly leads to serious complications, so the question of the possibility of predicting its development becomes extremely urgent. 

Why does type 1 diabetes occur?

Insulin, the hormone produced by beta cells of the pancreas, is responsible for the level of sugar in human blood. The destruction (destruction) of these cells leads to an acute shortage of insulin, which is why patients with this type of diabetes mellitus are forced to receive replacement insulin for life. But what becomes the trigger for the death of pancreatic cells, or what is the cause of the development of type 1 diabetes, despite more than 300 years of studying this pathology, is not known for certain.

There are several presumptive causative factors: heredity and external factors (including rubella viruses , Koksaki, some chemical and medicinal substances such as rat poison and streptozocin). 

Type 1 diabetes: risk factors

The underlying risk factors for developing insulin-dependent diabetes are genetic predisposition (the presence of diabetes in relatives), race and the presence of antibodies against pancreatic beta cells in the blood. Therefore, the risk is highest with a combination of these factors.

Let’s consider statistics in more detail:

• only 10-15% of people with type 1 diabetes have a family history of this disease (that is, at least 1 relative with the same diagnosis);
• if the mother has diabetes, then the risk for her child will be no more than 2%, if the father has 6%;
• if a brother or sister is ill with diabetes, the risk is about 5%;
• if both the brother / sister and one of the parents suffer from diabetes, the risk for the child is about 30%;
• if diabetes developed in one of the identical twins, then the risk of developing diabetes for the second twin rises to 30-50%;
• in people of the Caucasian race, the risk of type 1 diabetes is slightly higher than in Hispanics, Asians, and black people.

So can type 1 diabetes be predicted?

There are 3 types of markers that allow you to determine the risk of developing type 1 diabetes mellitus in a person: genetic, metabolic and immunological.

Genetic markers (genes of the histocompatibility complex, etc.) allow us to establish only a genetic predisposition, that is, to state that the risk of developing diabetes is 10-15 times higher than in individuals who do not have these genes. This means that it is impossible to predict specifically whether diabetes in a person with a genetic predisposition will develop. In addition, a sufficiently large number of diabetics lack such genetic markers. 

Metabolic markers (glucose tolerance test, insulin and C-peptide levels, glycosylated hemoglobin, fructosamine) begin to deviate from the norm only at the late stage of the preclinical period, with far-reaching destruction of pancreatic beta cells, that is, also unsuitable for detecting diabetes 1 type in the early stages. 

Immunological markers (titers of diabetes-associated antibodies) provide a unique opportunity to establish the beginning and nature of the course of autoimmune processes in beta cells of the pancreas with still normal results of tests for the content of C-peptide or glucose tolerance. 

Thus, only with the help of immunological tests can type 1 diabetes mellitus be predicted (in almost 90% of cases) long before the onset of the first symptoms of the disease.