Glucovance (Glyburide)
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TAKING COMMAND OF DIABETES: NON-INSULIN-DEPENDENT AND INSULIN-DEPENDENT DIABETES
Non-insulin-dependent diabetes
This is also called Type II or maturity onset diabetes and it is likely that you will have had your children before you find out that you are diabetic. There is an uncommon form of young onset diabetes called Mason type (maturity onset diabetes of youth or MODY) which is dominantly inherited. That means that half your children will inherit it. For other forms of Type II diabetes, if one parent has it, 1 in 7 of the children eventually develops diabetes. If both parents have Type II diabetes, up to three quarters of their children will eventually become diabetic. If you have identical twins and one develops diabetes, the other will too. Non-insulin-dependent diabetes can develop at any age and it is possible that as many as 25 per cent of first-degree relatives (that is parents, brothers, sisters and children) of a non-insulin-requiring diabetic may become diabetic at some time. Because it may produce very few symptoms for many years, some of them may never know that they are diabetic.
Insulin-dependent diabetes
The inheritance of insulin-dependent diabetes is easier to study because it usually produces severe symptoms and all family members with the condition are likely to know they have it. Some genetic markers are more likely to be found in people who are insulin-dependent diabetics than in those free from this condition. These are called the HLA antigens and are found on chromosome 6. People with either HLA-DR3 or HLA-DR4 are five times more likely to have insulin-dependent diabetes than those without these antigens. If you have both, the relative risk goes up to forty times. Many studies have looked at the brothers and sisters of insulin-dependent diabetics. Normally there is a one in four chance of two siblings sharing the same HLA genes. This increases to a one in two chance if both siblings have insulin-dependent diabetes. Further research has suggested that it is a gene close to the DR region called DQbeta which confers susceptibility to insulin-dependent diabetes. If one of the tiny components of the gene called aspartate is replaced by anything else in that particular position, the person may not be protected from developing diabetes if a trigger such as an infection appears later in life. Much work remains to be done and, as yet, these genetic markers are not specific enough to predict if someone is definitely going to become diabetic. If the mother has diabetes there is a one in a hundred chance that the child will develop diabetes. If the father has diabetes the risk of diabetes in his child increases to one in sixteen. If both parents have insulin-dependent diabetes the risk of their child developing diabetes may be as high as one in three, although older figures put it at one in twenty.
*63/102/5*
