- advertisement -

Antibodies and Monogenic diabetes

Discussion in 'Parents of Children with Monogenic Diabetes' started by Lovemyboys, Jul 19, 2011.

  1. Lovemyboys

    Lovemyboys Approved members

    Joined:
    Sep 19, 2010
    Messages:
    296
    My son was diagnosed at 13 months of age. They did testing at the hospital and the antibody tests came back positive (IA-2, Insulin AB, and GAD-65). Does this mean that he cannot have the monogenic form of diabetes? That was what I understood at the time, but just wanted to clarify.
     
  2. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    The only case I know of in which a person had a monogenic form of diabetes and was also antibody positive, the person was not able to go off of insulin because it was like having both the regular type 1 diabetes plus the monogenic diabetes.

    The antibodies cause a diabetes that cannot be treated with oral meds and that makes it pretty pointless to test for monogenic diabetes. I would think it'd be possible for a person to simply coincidentally have one positive antibody and also monogenic diabetes (because some people are antibody positive without diabetes, especially if it's just one antibody but also sometimes two antibodies and occasionally even three or four antibodies)- but it wouldn't be very likely.

    For somebody who was anitbody positive for three or four antibodies, I would say that it is vanishingly unlikely that the person has a diabetes that could be treated without insulin, and pretty unlikely that they have monogenic diabetes. I would only think it was worth testing if a family member definitely had monogenic diabetes (because in that case it might have implications for further children).
     
  3. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    My dd was DX at 13 months also, at the time she did not have antibody testing.

    I contacted the University of Chicago and they are sending us saliva tests for our family, they are interested in my non-d dd beacuse she is 4 for 4 on the auto antibodies, but no D.

    I have never read that if you have auto antibodies this means that you could not have a monogenic type of D, but I am not positive.

    This is how I contacted.
    http://www.monogenicdiabetes.org/how-can-i-be-tested

    It took along time for them to call me back, like weeks. But mr. Greeley did call me and spent allot of time talking to me.

    Good luck!

    PS we also participate in trial net.
     
  4. ChristineJ

    ChristineJ Approved members

    Joined:
    Dec 25, 2010
    Messages:
    303
    My son tested positive for 2 of the type 1 antibodies (IAA and GAD65) and yet he was recently diagnosed with MODY2 through genetic testing. As I understand it, having genetic susceptiblity to type 1 does not preclude also having monogenic mutation(s). It would certainly be unusual, but it can happen.

    Christine:)
     
  5. frizzyrazzy

    frizzyrazzy Approved members

    Joined:
    Dec 23, 2006
    Messages:
    14,141
    there is no "the" monogenic form of diabetes. There are multiple forms of monogenic diabetes (see my other thread from a few weeks ago). But your question really is "does this mean that he cannot have neonatal monogenic diabetes" .

    Just also remember, most forms of monogenic diabetes behave just like type 1 and most do require insulin. There are only a few types of monogenic diabetes which allow the patient to go off insulin. Types of neonatal and types of mody. But most other monogenic types of diabetes will still require insulin.

    Again, please see this link:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1894829/
    there is no disease just simply called Monogenic diabetes. There are various types of diabetes which are monogenic in nature, meaning caused by one gene.
     
  6. Lovemyboys

    Lovemyboys Approved members

    Joined:
    Sep 19, 2010
    Messages:
    296
    Thanks, that makes since. I just got to thinking that if there are people who are positive for the antibodies that don't have diabetes, then there might be a chance that even though he has the antibodies, he might have the monogenetic form. I read a little about it and he fits the profile a little bit, like having low fasting hyperglycemia, but also I know he's still honeymooning some, so I don't know if that really tells us anything.

    Thank for the contact info. I think I'll contact him and see what he says. I think at this point, with no other family member diagnosed, that the likelyhood of the monogentic form is very very slim. I would just be so sad if this was something that could be treated without insulin and he spent years taking insulin and all the stuff that goes along with it.

    Wow! I don't know a lot about MODY2, does it still need to be treated with insulin (or is it treated differently from Type 1)? I guess my thoughts are if the treatment isn't any different, then I'm not sure it's worth perusing. But if there's a change in treatment plan then I think I need to maybe look into this further.
     
  7. Lovemyboys

    Lovemyboys Approved members

    Joined:
    Sep 19, 2010
    Messages:
    296
    Thank you for the information. I realize that it's a very, very long shot that he could get off insulin. Just every once in a while denial rears its ugly head when I think of him dealing with this for a lifetime.
     
  8. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    That is where I am at, long shot.

    But I think that if you know that there is a mutated gene even if it does not change your insulin regime then that is usefull information.
     
  9. redcurls3

    redcurls3 Approved members

    Joined:
    Jan 1, 2006
    Messages:
    137
    I don't have access to the whole article but the abstract of this article does tell about a patient with the KCNJ11 mutation with a positive antibody test at onset http://www.ncbi.nlm.nih.gov/pubmed/19692135

    Though this child was dx at 12 weeks so the chance of a monogenic cause was much more likely. So being positive for an antibody doesn't necessarily mean it's not a monogenic cause, though it is rare.
     
  10. ChristineJ

    ChristineJ Approved members

    Joined:
    Dec 25, 2010
    Messages:
    303
    The treatment for MODY2 can vary from diet/exercise to sulfonylureas to low dose insulin. There are about a hundred different MODY2 mutations, so the clinical presentation can vary depending on the individual and the particular mutation they have.

    Some of the other MODY types can be controlled initially with diet/exercise but they often progress to needing sulfonylureas or insulin. Usually the doses of insulin are low for extended periods of time, though, like a long "honeymoon".

    Christine
     
  11. Lovemyboys

    Lovemyboys Approved members

    Joined:
    Sep 19, 2010
    Messages:
    296
    I agree, the information would be helpful, especially as more information about these other variants is discovered. I guess as parents we'll search under every rock to try to find something to help our babies.

    I can just see the abstract too. I'm going to search around to find the whole article, it'll be interesting to see what treatment plan the child was/is on, etc. Thanks for posting the link!

    100 different mutations! I had no idea.

    Thanks everyone for the information. I have a good start at learning more about this so I can have an intelligent conversation with the endo at my son's next appointment!
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice