Type 1 Diabetes Overview

Prevalence of Type 1 Diabetes is about 5% of the total-suspected Diabetic population or about 10% of the known Diabetic population in the US
Peak onset occurs in the second decade of life (ages 10-14) with another peak in the sixth decade although actual onset may occur at any age
- Prevalence is 1.7 cases/1000 < 20 years of age or roughly 127,000 individuals
  - Primarily Caucasian
  - Less in Hispanics
  - Lowest in Blacks or Asians
- Incidence is 18 new cases/year/100,000 < 20 years of age

Risk of Type 1 Diabetes
- If no diabetes in the family:- 0.1% , otherwise
- If identical twin with Type 1 Diabetes:- 25-50%
- If either parent has diabetes: (multiply the risk by 2 if parent was diagnosed with Type 1 Diabetes before age 11)
  - If father has Type 1 Diabetes:- 6%
  - If mother was younger than 25 at propositus's birth:- 4%
  - If mother was 25 or older at propositus's birth:- 1%
Ninety (90) % of Type 1 cases are positive for a non-aspartic acid amino acid residue at position HLA B57,

or VQbeta macrophage receptors, or Islet Cell Antibodies (anti-Glutamic Acid Decarboxylase 64kd, anti-tyrosine phosphatase (Rabin Ag512/IA-1), anti-insulin)

Concensus seems to be emerging about the protective role of IL-4 ("InterLeukin-4") in its relation to other anti-inflammatory cytokines in preventing insulitis and Type 1 diabetes

Screening and a clinical trial is available for 1st degree relatives of patients with Type 1 Diabetes at the NIDDK Diabetes Prevention Trial - Type 1 (or call 1-800-425-8361)

Pathophysiology includes islet-cell antibody mediated insulitis, beta-cell destruction, and virtually absolute insulinopenia

This process seems to be characterized by more rapid progression in children

This process may be characterized by slower progression in adults

Classic symptomatology includes the quick-onset of polyuria, polydipsia, polyphagia, and weight-loss
Insulin requirement is absolute and life-sustaining

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