Family history of type 2 diabetes and characteristics of children with newly diagnosed type 1 diabetes

Taina Härkönen,Maaret Turtinen,Jorma Ilonen,Anna Parkkola,Mikael Knip

doi:10.1007/s00125-020-05342-x

Taina Härkönen, Maaret Turtinen + Show 3 more

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https://doi.org/10.1007/s00125-020-05342-x

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Abstract

Aims/hypothesisShared aetiopathogenetic factors have been proposed in type 1 diabetes and type 2 diabetes and both diseases have been shown to cluster in families. Characteristics related to type 2 diabetes have been described in patients with type 1 diabetes with a positive family history of type 2 diabetes. We wanted to characterise the family history of type 2 diabetes and its possible effects on the phenotype and genotype of type 1 diabetes in affected children at diagnosis.MethodsA total of 4993 children under the age of 15 years with newly diagnosed type 1 diabetes from the Finnish Pediatric Diabetes Register were recruited (56.6% boys, median age of 8.2 years) for a cross-sectional, observational, population-based investigation. The family history of diabetes at diagnosis was determined by a structured questionnaire, and markers of metabolic derangement, autoantibodies and HLA class II genetics at diagnosis were analysed.ResultsTwo per cent of the children had an immediate family member and 36% had grandparents with type 2 diabetes. Fathers and grandfathers were affected by type 2 diabetes more often than mothers and grandmothers. The children with a positive family history for type 2 diabetes were older at the diagnosis of type 1 diabetes (p < 0.001), had higher BMI-for-age (p = 0.01) and more often tested negative for all diabetes-related autoantibodies (p = 0.02).Conclusions/interpretationFeatures associated with type 2 diabetes, such as higher body weight, older age at diagnosis and autoantibody negativity, are more frequently already present at the diagnosis of type 1 diabetes in children with a positive family history of type 2 diabetes.Graphical abstract

Highlights

Diabetes mellitus is characterised by hyperglycaemia and inability to control glucose levels
History for type 2 diabetes has been reported in 1–70% of patients with type 1 diabetes, depending on the age of the patients and the time elapsed since type 1 diabetes diagnosis, as well as the extent of family members included in the analysis [3, 5,6,7, 10,11,12,13,14,15,16,17,18,19,20]
In our cohort of children newly diagnosed with type 1 diabetes, only 2% of the children reported type 2 diabetes patients among their immediate family members, whereas type 2 diabetes in grandparents was common (36% of the children reported affected grandparents)

Summary

Introduction

Diabetes mellitus is characterised by hyperglycaemia and inability to control glucose levels. In addition to less frequent subtypes, diabetes has traditionally been classified into two major diseases: type 1 diabetes, which is immune-mediated, and type 2 diabetes, usually related to insulin resistance. This classification is not always straightforward, and Diabetologia (2021) 64:581–590 shared aetiological and pathogenetic processes have been suggested in both major diabetes types [1, 2]. In paediatric patients with type 1 diabetes, 0–13% have been reported to have first-degree relatives and 32–52% extended family members affected by type 2 diabetes [5, 6, 10, 15, 17, 20]

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