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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.
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.