Fertility and genetic advice in diabetics

Abstract

The improved fertility of diabetics and the progress of diabetic morbidity imply the necessity of restricting procreation. The opposite notions of fertility and prevention may be reconciled by the genetic counselling if the pedigree, the mode of transmission of diabetes, the financial situation, ethical point of view, etc. are taken into account. Details are given concerning this advice and the arguments sustaining it, especially the number of diabetics in the pedigree and the penetrance of diabetes. The authors criticize mixed marriages which increase the number of diabetogenic genes in the population. On the contrary they advise marriage between diabetics in order to limit the number of births by «autoprophylaxis» and thus prevent the dissemination of diabetogenic genes. The arguments lending support to mixed marriages are also listed, with detailed advice for special cases. Genetic advice would be more readily accepted if diabetics were taught to draw up their pedigree and keep it up to date.