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1.Risk of Type 1 in
general population ranges from 1 in 400 to 1 in 1000. The risk rises
substantially to 1 in 20 to 1 in 50 in the offspring of those with Type
1.
2.Genetic
predisposition to Type 1 is the result of HLA-DQ coded genes for disease
susceptibility off set by genes that are related to disease resistance.
Genes that produce resistance are frequently dominant over those that
produce disease susceptibility.
3.Antibodies: Positive
GAD, Insulin and Islet Cells autoantibodies (IAA & ICAs)
4.Viral triggers are
suggested by the association of Type 1 with congenital rubella and
coxsackie B4 infection. Bovine serum albumin (BSA) is thought to be an
environmental trigger. BSA specific antibodies are found in the
majority of kids with newly diagnosed diabetes, thus early exposure to
cow’s milk may be a potential determinant. There is a higher rate in
non-breastfed women.
5.Environment:
Some chemicals
and drugs specifically destroy pancreatic cells.
6.Hyperglycemia and
symptoms consistent with the diagnosis of DM develop only after 90% of
the secretory capacity of the beta cell mass has been destroyed.
Type 2:
1. Typical: over 40…the older you get, the higher your risk goes. Although, Type 2 in children is becoming much more frequent. 2. People overweight are at higher risk. 3. Sedentary lifestyle increases your risk of developing Type 2. Excessive abdominal (visceral) fat introduces greater threat of Type 2 than does lower body obesity. 4. Family history….does not have to be first degree relative. No specific HLA type is identified. Where 1 identical twin is affected the incidence is close to 100%. Off springs have a 15% chance and 30% risk of Impaired Glucose Tolerance
5.Women who had
gestational diabetes, have a 50% risk of developing Type 2 within 5-10
years
6.Certain ethnic groups
increase the susceptibility to Type 2, such as African American, Native
Americans, Asian, Pacific Islanders.
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