Children of Type 2’s Show Delayed Onset of Type 1 Diabetes
This parental history is also associated with increased rates of metabolic syndrome and a metabolic syndrome related to insulin resistance.
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Previous research has shown that type 1 and type 2 diabetes cluster in families, according to the report in the January issue of Diabetes Care. Yet, few studies have examined how a family history of type 2 diabetes impacts the offspring with type 1 disease.
To investigate, Dr. Per-Henrik Groop, from Helsinki University Hospital, and colleagues analyzed data from 1860 patients with type 1 diabetes who were enrolled in the Finnish Diabetic Nephropathy (FinnDiane) Study. The subjects included 620 with and 1240 without a parental history of type 2 diabetes.
On average, the onset of type 1 diabetes occurred at 17.2 years in the group with a family history compared with 16.1 years in the group without parental diabetes (p = 0.008).
Metabolic syndrome was diagnosed in 44% of patients with a parental history of type 2 diabetes and in 38% of controls (p = 0.013). A metabolic profile related to insulin resistance was also more common in the parental diabetes group.
Conversely, a parental history of diabetes did not affect blood pressure, HLA genotype distribution, or the occurrence of diabetes complications, the report shows.
On multivariate analysis, a parental history of type 2 diabetes was an independent predictor of type 1 diabetes onset, body mass index, triglyceride levels, and insulin dose per kilogram.
"To our knowledge, this is the first study to show that a positive parental history of type 2 diabetes is associated with the metabolic syndrome in patients with type 1 diabetes," the authors note. "The association was weak when the metabolic syndrome was analyzed as a dichotomous variable but strong when it was analyzed as a continuous score."
Practice pearls
A parental history of type 2 diabetes is associated with a later onset of type 1 diabetes, the metabolic syndrome, and a metabolic profile related to insulin resistance.
A parental history of type 2 diabetes is not associated with blood pressure, late diabetes complications, or HLA genotype distribution.
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