# Advances in medical care have led to type 1 diabetes boom



## Northerner (May 6, 2016)

Researchers from the University of Adelaide say the global increase in cases of type 1 diabetes is directly linked to advances in medical care, with the underlying genetics of the disease more likely to be passed from one generation to the next.

In a paper published in _BMJ Open Diabetes Research & Care_, researchers looked at the prevalence of type 1 diabetes in 118 countries and changes in life expectancy from 1950 to 2010.

After applying a measure known as the Biological State Index to the data, they found that the rapid increase in type 1 diabetes over the last few decades was directly linked with increases in human life expectancy, especially in Western countries -- and therefore a reduction in natural selection.

https://www.sciencedaily.com/releases/2016/05/160505104741.htm


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## Robin (May 6, 2016)

That makes sense. In former times, a lot of people with genetic disorders must have tidied themselves off the planet before they got a chance to reproduce.


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## Annette (May 6, 2016)

But wouldn't that imply that I'm  T1 because my parents were T1 because their parents were T1 etc etc (with the odd missing generation cos thats what genes do)?
So where do I fit in (and many hundreds/thousands) who have no T1 in their family history? 
I havent read the article  (sorry, bit hard on a phone) but does it (or anything else) look at how many more T1s with family history v those without?


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## Robin (May 6, 2016)

Annette Anderson said:


> But wouldn't that imply that I'm  T1 because my parents were T1 because their parents were T1 etc etc (with the odd missing generation cos thats what genes do)?
> So where do I fit in (and many hundreds/thousands) who have no T1 in their family history?
> I havent read the article  (sorry, bit hard on a phone) but does it (or anything else) look at how many more T1s with family history v those without?


I wonder if it's just a general auto immune link. Do you have family members with other stuff? I've only come across one more diabetic in our family, my great grandmother, who managed to produce 10 children before dying of it at the age of 60, just before insulin injections were invented. (No idea which type it was, but I didn't develop Type 1 til I was over 50) but we do have other autoimmune conditions peppered across that side of the family.


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## Matt Cycle (May 6, 2016)

I always thought there was no family history of diabetes in my family.  However, I remembered on diagnosis at hospital my Mum mentioning someone to the medical staff when they asked about family history of diabetes.  I recently asked my Mum about this and she said it was 'Auntie' Flo - my Grandma's cousin on my Mum's side.  I think that makes her my Mum's first cousin once removed and my first cousin twice removed.  Not exactly a close relative but a link nonetheless.  My Mum remembers her visiting their house when she was a child and she visited her - so this would have been in the late 40's/early 50's. My Mum knew this lady was diabetic as they told my Mum and she used to produce a 'huge' needle and glass syringe.  I'm assuming from this info that she was a T1 injecting insulin.  Apparently she didn't have any children and other than that my Mum doesn't know much else.


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## Annette (May 6, 2016)

Robin said:


> I wonder if it's just a general auto immune link. Do you have family members with other stuff? I've only come across one more diabetic in our family, my great grandmother, who managed to produce 10 children before dying of it at the age of 60, just before insulin injections were invented. (No idea which type it was, but I didn't develop Type 1 til I was over 50) but we do have other autoimmune conditions peppered across that side of the family.


Nope, I really am an anomaly. No other AI in the last 3 generations. Or in my current generation for 1 displacement either way. (There is a 2nd cousin with T1 now. Thats it.) I'm also the only one with eczema. Something has screwed with my genes alone, it appears...


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## khskel (May 6, 2016)

No history in my family either


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## Northerner (May 7, 2016)

My Dad had psoriasis, developed in his early 40s.


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## KookyCat (May 7, 2016)

Genetically speaking it wouldn't have to be T1, any autoimmune will do, and the gene in question could be passed for several generations without expression until boom someone breeds with another recessive gene carrier and you're on.  From what I've read It's very hard to map the genetic link with T1 because every human being is genetically unique (even twins) so in the case of autoimmune the leading theory is you've got a Timmy gene which switches the immune system into hyperactivity, but the bit of the body it has fun with is determined by genetic weakness/variation.  So to get type 1 you need Timmy gene and X, if you have Timmy gene and Y you get Crohns, Timmy gene and A and you've got rheumatoid arthritis etc.  Timmy gene is likely to be recessive btw because if it were dominant you'd see obvious inheritance.  That autoimmune Timmy gene can also lie dormant for tens of generations until someone hits the jackpot genetically speaking.  My family is like autoimmune city we've got the lot, but only one other T1 (also a late bloomer), if I had kids there'd be a 50/50 chance I'd pass on my wonky immune gene, and a 50/50 chance I'd pass on my X gene.  There is some evidence to suggest by the way that T2 is caused by the wonky X gene in the absence of the wonky immune system gene which is why you get clusters of T1 and T2 in the same genetic line.  the really interesting bit if you're a science nerd is the new realisation that recession and dominance are a continuum rather than absolutes.  So they used to think that if a gene was recessive it was just that and the dominant partner just over ruled it.  Now they're starting to realise you can have strong recessive and weak dominant, which means the recessive can in some instances have an action in the body, particularly as we age, which could account for older diagnosis of T1.  There's a massive cluster of autoimmune arising around the age of 40, and 40 is a magic age because it's the point at which the body starts to actively deteriorate genetically speaking (that's why most cancers appear after 40), so I guess if you've got a super charged recessive and a weak dominant the balance can shift...

Anyone interested in genetics should read the immortal life of henrietta lax (I've probably spelt her surname wrong) it's absolutely fascinating and very sad, but so interesting, and just about to be made into a film with Oprah Winfrey I'm told


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## Bloden (May 7, 2016)

khskel said:


> No history in my family either


Same here. Then my cousin's little girl was dx 3 and a half years after me. So maybe there is a family history.


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## Copepod (May 7, 2016)

Thanks KookyCat. I saw thus thread last night and was considering doing an explanatory post about genetics, but now there's no need! 
Can't remember Henrietta's surname either, but her cell line is called HeLa for the first 2 letters of each of her names.
One other point is that auto immune conditions, like all conditions with genetic components, can appear spontaneously, without history, when a new error occurs in DNA.


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## Ljc (May 7, 2016)

I have just bought this book not started reading it yet. 
Her name is  Henrietta Lacks.


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## Annette (May 7, 2016)

Copepod said:


> One other point is that auto immune conditions, like all conditions with genetic components, can appear spontaneously, without history, when a new error occurs in DNA.


So don't those people  (like, probably, but not definitely (given Kookys very concise summary of genetics) me), need to be removed from any study of why are there more T1s about? Because if I'm T1 due to a mutation in my genes (as I'd always supposed) rather than an inherited mutation as most studies seem to presume, they're saying I'm alive because my parents didnt die of a gene mutation disease, which wouldnt be the case. Only if they can remove cases where the mutation happens in the current generation and still get the same statistical indicators can they truly claim there's more of us due to our parents not dying due to AIs killing them pre-reproduction.
(For parents, read 'previous generations', obviously ).


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## KookyCat (May 8, 2016)

Ljc said:


> I have just bought this book not started reading it yet.
> Her name is  Henrietta Lacks.



I loved it, so I hope you enjoy it, and btw her family are still fighting...I won't tell you what for don't want to spoil it!


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## Peapod87 (May 8, 2016)

My great auntie was type 1 but then on diagnosis I found out quite a lot of my relatives such as aunts and uncles maybe twice removed all have or had type 2 like by a lot I mean at least 5-6 its mad I had no idea beforehand.


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## Copepod (May 8, 2016)

Annette Anderson said:


> So don't those people  (like, probably, but not definitely (given Kookys very concise summary of genetics) me), need to be removed from any study of why are there more T1s about? Because if I'm T1 due to a mutation in my genes (as I'd always supposed) rather than an inherited mutation as most studies seem to presume, they're saying I'm alive because my parents didnt die of a gene mutation disease, which wouldnt be the case. Only if they can remove cases where the mutation happens in the current generation and still get the same statistical indicators can they truly claim there's more of us due to our parents not dying due to AIs killing them pre-reproduction.
> (For parents, read 'previous generations', obviously ).


There are complicating issues to consider here. People don't necessarily die of autoimmune diseases, and even if they do die of such diseases, they may have reproduced before problems became evident. So, for studies looking a heredity, it's important to take a detailed family medical history, asking about grandparents, parents, siblings, aunts, uncles, children. It's a known complication in genetic studies / clinical history that not all fathers are actually the genetic father of a child they consider to be their own. Obviously, unless there's an accidental swap of babies in hospital, for example, mothers and babies can be linked with confidence.


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## TheClockworkDodo (May 8, 2016)

Annette, I'm an anomoly too - no diabetes of any sort in my family, and no other autoimmune disease of any sort except for one cousin with hypothyroidism, which apparently is common enough that when I mentioned it to consultant endocrinologist he said "everyone has a cousin with hypothyroidism" - he couldn't believe I didn't have a parent or grandparent or other ancestor with an autoimmune disease somewhere.

But I'm pretty sure my diabetes is a direct result of my ME causing my immune system to start attacking bits of me (I test positive for antibodies to adrenal and for antibodies for thyroid, and my GAD antibodies result was off the scale and over the hills and far away).

As to what caused the ME, which they now think is also an autoimmune disease? - well, that would be the question for me.  There are certainly ME genes, but they don't in themselves cause ME, just cause a propensity to it.  Other things like over-use of antibiotics and environmental factors might also cause a propensity to it.  It's usually triggered by a virus like flu or glandular fever, but sometimes by another physical trauma such as an allergic reaction.  A lot of people think the overall cause is a retrovirus of some sort, but if so, no-one's managed to find it yet ...


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## KookyCat (May 9, 2016)

It is possible to have a gene in your family line that doesn't express itself because it's recessive.  My type of EDS is passed on a recessive gene and requires the 1in a million chance of two recessives creating a child.  My family was gene mapped when I was a kid, and I get updates from them which is always interesting.  Both parents carry the gene (there is a visible marker a thumb where the top joint bends backwards to a 90 degree angle), but neither have any super bendiness other than the thumb, none of my immediate relatives have EDS so ostensibly there'd be no family history, in fact it wasn't considered a genetic disorder until relatively recently since the bendy thumb wasn't known to be a marker of the recessive gene.  So really until they properly understand the exact genetic link it will always be supposition on their part.  Incidentally EDS people traditionally have issues with autonomic control and glucose regulation, which is probably why hypos don't bother me much, I had them anyway by virtue of the EDS.  I digress, the assumption that better healthcare has increased the numbers of T1 would seem to suppose a direct familial inheritance which doesn't seem to tally with the evidence, although it's likely to hold true in future generations since the survival rate for T1 has improved massively in recent years, so maybe that's what they're getting at?  Still good to get the brain cells working.


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## TheClockworkDodo (May 13, 2016)

KookyCat said:


> Incidentally EDS people traditionally have issues with autonomic control and glucose regulation, which is probably why hypos don't bother me much, I had them anyway by virtue of the EDS.



I suspect the same is true for me with ME, Kooky.


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## KookyCat (May 14, 2016)

TheClockworkDodo said:


> I suspect the same is true for me with ME, Kooky.



Well there must be a number of similarities because my consultant (rheumatology not diabetes) was talking about how one particular type of EDS is often misdiagnosed as either ME or Chronic fatigue (I know not to get him started on the confusion between those two now!).  The POTS clinic I used to attend was all hyper mobiles and ME folk so I'm guessing they have common autonomic threads.  Come to think of it I haven't had any POTS moments for a while, must be a postural hypotension phase next then


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## TheClockworkDodo (May 14, 2016)

POTS is indeed common in ME, there do seem to be a lot of overlaps.  I don't have postural hypotension, but I have supine hypotension, so instead of falling over when I stand up, I lie down and then can't get up again


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## KookyCat (May 15, 2016)

Oh now that's just solved a mystery for me, I had that in hospital when in the cardiac ward, I have low blood pressure anyway and lying down apparently made it so low you couldn't limbo under it.  They kept calling it something, I thought they said lupine (which just confused me) of course supine makes more sense.....then I'd stand up and my heart rate would go through the roof, I was too confused to explain the POTS (couldn't even remember my name!), but not as confused as they were.  Thankfully I remembered consultants name who explained I wasn't having some odd cardiac crisis.

Oh what a pair we would make on a beach


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## trophywench (May 15, 2016)

whoever would have imagine that wolves bodies do that !


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## TheClockworkDodo (May 15, 2016)

KookyCat said:


> couldn't even remember my name!



Been there too, luckily with very nice phlebotomist who just said "been a long day?" and waited until I did remember it!

Giggling at the thought of lupine hypotension, all the rest of the pack having to help them up the way R has to sit me up sometimes


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