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From Atlanta Georgia:

I have a diabetic child.

  1. I tested negative for the ICA test last year. Do I need to get retested, and if so how often would I need to get that done?

  2. If a child receives a high risk HLA type, is this the protein that identifies a cell as non-self? Are there other types besides self or non-self?

  3. Is a child a more likely candidate for diabetes if the child receives the high risk HLA type from both mother/father vs. a child who receives the high risk from only one parent? I saw a reference, and I am hoping to locate it, that both parents have to pass the high risk HLA to a child for the possibility of diabetes to develop

  4. What test can determine which or both parents carry the precipating gene if both test negative for ICA?

  5. At what age could/should our youngest son who is 2.5 years old be tested? Our doctor said that we could do it at three but I have been told not until the child is five. We would be happy to have him tested. At the clinic what age do you all test the siblings?


  1. It depends what you really mean by 'need.' If you already have one diabetic child you know that one or both parent most probably has a susceptibility gene. probably you both have a mild one. The likelehood then of either of you now becoming antibody positive is rather small, although a complete table of risk is not available. Some people though do get tested once a year if they feel that they are especially at risk and one antibody conversion has been seen in a man in his 50's.

  2. All the proteins in an individual are 'self'; but the HLA ones on the cell surface are the ones that identify the cell to the lymphocytes of the immune system. 'Non-self' proteins usually belong to bacteria or viruses; but sometimes to grafted organs and in the auto-immune disorders the body's own lymphocytes wrongly percieve some cell surface antigens to be 'non-self' and set about getting rid of them.

  3. A child is more likely to get diabetes if a high risk gene is inherited from both parents than from just one. If the inheritance is from one parent only, diabetes is more likely to occur if the genes come from the father rather than the mother. Routine testing does not cover ALL known genes, usually just a total 22 and the most common high risk ones areDQA0301/DQB0302 and DQA0501/DQB0201. There is also a protective gene DQB0602.

  4. An HLA test could determine the source of the high risk gene; but the test is still a research tool in the diabetes area and only a small number of research laboratories carry it out.

  5. In theory a child can be tested at birth; but it is usually deferred for nine months to avoid contamination from maternally inherited antibodies. Unless there is clinical evidence of diabetes it might just as well be deferred until three years of age which is the earliest a child would be accepted into DPT-1, the clinical trial of prevention.


Original posting 27 Nov 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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