Handing Down the Genes. Part 1 (of 3)

This is the beginning of our three part series “Handing Down the Genes.”  Part I: “When to Worry-and When Not to-About Your Child’s Increased Risk for Diabetes.”

The little things are adding up again, making me worry. First, the bed wetting. It’s not that he has started wetting the bed; it’s that he never stopped. And he just turned seven. And it’s worse lately. Even the “Good Nites Underpants for Big Boys” aren’t sparing the sheets and blankets. He’s an extremely deep sleeper, so that’s probably the reason. Or…

Then there’s the way he’s always thirsty, the comments about how skinny he’s gotten from relatives who haven’t seen him in a year, the irritability, and now, even after a large glass of sweet tea (usually not allowed), definite lethargy. The recent baseball games and practices could account for the thirstiness, he could be losing baby fat, and he did stay up really late last night, so that might be why he’s tired. Or… 

I want to reach for my glucose meter, but I know how that plays out. Coaxing, bribing, crying (“No, don’t stick me with that needle!”). Then, when I give in – to avoid a chase through the house – “Momma, do I have diabetes?” Great. Now I’ve worried him.

So how are parents with diabetes supposed to balance concern over their children’s increased risk for the disease with a desire not to cause undue alarm?

I decided to start with the basics.

What are the risks, anyway?

Like most parents who have diabetes, I knew that type 1 and type 2 have a genetic element and that my children are at a higher risk of developing the disease than kids without a family history. But I didn’t know by how much my condition increased their risk.

According to the American Diabetes Association, if you’re a man with type 1 diabetes, your child has a six percent chance of developing the disease. If you’re a woman with type 1 and your child was born before you were 25, the child’s risk is four percent; if your child was born later, his or her risk is one percent. Double the odds if you developed diabetes before age 11. Your child’s risk of getting diabetes is between 10 percent and 25 percent if both you and your partner have type 1. The risk for siblings of children with type 1 is akin to having one parent with the disease. Among the general population, the odds of developing type 1 are less than one percent.

“It [the increased risk] is not necessarily a lot,” says Dr. Gabriella Grinstein, pediatric endocrinologist at the Friedman Diabetes Institute at Beth Israel Medical Center in New York. “We’re talking only a 20 percent chance, assuming that both parents have it.” She notes that over 75 percent of the children she treats for type 1 have no family history of the disease.

Type 2 diabetes is more common among the general population – the current risk is about 10 percent, says Dr. Henry Prost, endocrinologist and medical director of the Baylor Diabetes Center in Dallas – and it’s rising. ADA estimates that one in three Americans born in 2000 will develop type 2. The tendency to run in families also is stronger in type 2. If you have type 2, Prost says, the likelihood that your child will develop the same condition is 30 to 50 percent. If both you and your partner have the disease, the risk is 50 to100 percent.

“This should be a very big concern,” Grinstein says. “With the obesity epidemic in this country, type 2 is affecting people at younger ages than in the past. Developing type 2 at 50 is much different from developing it when you’re 10 years old.” A person who gets type 2 diabetes in his or her fifties might not experience complications until age 70, she explains. But a child who gets it at 10 could have significant health issues in his or her twenties.

Preventing type 2

The good news for those with type 2 is that there are things you can do to lessen your child’s risk. Nancy Heinrich, an epidemiologist who specializes in diabetes and the founder of Growing Healthy Kids, a Vero Beach, Florida-based non-profit organization aimed at preventing childhood obesity and diabetes has some simple guidelines.

Tune in next Saturday for Part II, “Preventing Type 2 for Children” from Olivia Grider