Type 1 and Type 2 Diabetes

What Do They Have in Common?

  1. Tiinamaija Tuomi
  1. From the Department of Internal Medicine/Diabetology, Helsinki University Central Hospital; the Institute for Diabetes Genetics, Folkhalsan Research Center, Helsinki, Finland; and the Research Program for Molecular Medicine, University of Helsinki, Helsinki, Finland
  1. Address correspondence and reprint requests to Dr. Tiinamaija Tuomi, Department of Internal Medicine/Diabetology, P.O. Box 340, Helsinki University Central Hospital, FIN-00029 HUS, Helsinki, Finland. E-mail: tiinamaija.tuomi{at}hus.fi

Abstract

Type 1 and type 2 diabetes frequently co-occur in the same families, suggesting common genetic susceptibility. Such mixed family history is associated with an intermediate phenotype of diabetes: insulin resistance and cardiovascular complications in type 1 diabetic patients and lower BMI and less cardiovascular complications as well as lower C-peptide concentrations in type 2 diabetic patients. GAD antibody positivity is more common in type 2 diabetic patients from mixed families than from common type 2 diabetes families. The mixed family history is associated with more type 1–like genetic (HLA and insulin gene) and phenotypic characteristics in type 2 diabetic patients, especially in the GAD antibody–positive subgroup. Leaving out the extreme ends of diabetes phenotypes, young children progressing rapidly to total insulin deficiency and strongly insulin-resistant subjects mostly with non-Europid ethnic origin, a large proportion of diabetic patients may have both type 1 and type 2 processes contributing to their diabetic phenotype.

Footnotes

    • Accepted May 3, 2005.
    • Received March 12, 2005.
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