Studies support the existence of a genetic contribution to both type 1 and type 2 diabetes, and additionally suggest a relationship between both types of diabetes. The rapidly growing worldwide epidemic of type 2 diabetes has been partially explained by obesity and the sedentary lifestyle. However, familial factors also seem to play a major role in the pathogenesis of type 2 diabetes.). The fact that type 1 and type 2 diabetes cluster in families suggests that some patients may even have a double form of diabetes.
Objective: To report the clinical presentation and autoimmune markers of children and adolescents with FT1DM and FT2DM.
Patients and methods: All children with onset of FT1DM and FT2DM 216 years of age registered between 2012 and 2016 were studied. We those who had one or more first-degree relatives (parents and siblings) with T1DM (FT1DM) (n=108) and those with one or more first-degree relatives with type 2DM (FT2DM) (n=13). The clinical presentation and biochemical data including the prevalence of beta cell autoimmunity (Anti GAD, anti-islet cell and anti-insulin antibodies(ICA), thyroid function (Free thyroxine (FT4) and TSH), anti-thyroid peroxidase antibody (ATPO) and anti-tissue transglutaminase (ATT) at their first presentation were recorded, described and compared (Table 1).
|Anti GAD +ICA2||56.5%*||0%|
|Free T4 (<11 pmol/l)||2.94%*||0%|
|TSH (5.610 U/ml)||3%||8.3%*|
|TSH (>10 U/ml)||0.99%||8.3%*|
|ATPO (>100 IU/ml)||35.5%||30%|
|ATPO (>100 IU/ml)+Normal TFT||28.26%||20%|
|ATPO (>100 IU/ml)+hypothyroid (T4<11 pmol/l) or TSH >10 U/ml)||7.7%||0%|
|ATPO (>100 IU/ml)+(TSH 5.610 U/ml)||2.2%*||0%|
|ATPO (<100 IU/ml) +hypothyroid (T4<11 pmol/l or TSH >10 U/ml)||1.1%||10%*|
|ATT IgA>10 U/ml||19.8%*||0%|
|ATT Igg >10 U/ml||15.4%*||0%|
|0 to 4 years||40.7%||0%|
|5 to 9 years||31.48%||0%|
|10 to 14 years||27.78%||100%*|
Conclusion: Children with FT2DM had a significantly high prevalence of ICA, anti-GAD and ATPO antibodies. In addition, they did not have ketosis at their first presentation with hyperglycemia. This presence of autoimmune markers in a good number of our patients with FT2DM point out to a probable familial-genetic mixture between FT1DM and FT2DM.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology