My oldest son Jason was diagnosed with diabetes at just 17 months old.  The classic signs and symptoms were already present: excessive thirst, excessive urination and unexplained weight loss. He was hospitalized for four days before he could come home. 

My younger son, Marc, was diagnosed with diabetes in a much different way, through a process called autoantibody testing. This test was new several years ago when my son took it, but is fairly mainstream today.  This simple blood test for autoantibodies can help predict with relative certainty the risk a person has of developing diabetes. This test is done on first-degree relatives of people with diabetes.

The antibodies are measured in a lab and a degree of relative risk of diabetes is determined. My son’s degree of risk was very high due to his very high autoantibody titer, and the doctor told me that my son would probably become diabetic within a year or less. 

With this important piece of information I could monitor Marc for fluctuations in blood sugar readings. When Marc’s post-prandial blood sugars began to rise to over 180, our endocrinologist prescribed a low dose of long-acting insulin to prolong his “honeymoon” period, when his blood sugars stayed stable on very low does of insulin. (Post-prandial or post-meal blood sugars are the first to rise as the pancreas loses its’ insulin producing ability.)

This proves that type 1 diabetes is essentially an autoimmune disease. Your antibodies start to attack the beta cells in the pancreas, mistaking them for “invaders,” or foreign harmful cells. Over time, the pancreas becomes unable to produce adequate insulin to keep blood sugars regulated. 

It is not until most of the beta cells have been destroyed that symptoms of diabetes start to emerge. This is why antibody testing is such a breakthrough. If we can identify diabetes earlier in the disease process, cellular damage such as complications of diabetes can be minimized.

Drug companies are working on a treatment for this phase of the autoimmune attack, but the drugs that have been tried thus far are in the class of drugs known as immunosuppressants. The problem has been that along with suppressing the antibodies that attack the beta cells, these drugs also suppress the “good” antibodies in the body, leading to what could be serious side effects like infection.

If you have relatives thinking about getting this predictive blood test, let them know the facts. The decision of whether to test or not is a very personal one. Some people have trouble knowing something may happen before it does. But, in my opinion, being an informed patient is always the best plan. Armed with the proper knowledge, you can be comfortable making choices that are good for you and your family.

Remember that antibody testing is also used for other autoimmune diseases such as lupus, rheumatoid arthritis and a few others. The autoantibody testing for the beta cell antibody is very specific for diabetes, and can be used to predict disease progression as opposed to confirm diagnosis.

Predicting type 2 Diabetes: The Future

British researchers have reported that it may be possible to predict type 2 diabetes before symptoms ever occur. This new test (which, as of this writing, has not been approved yet) will be a huge advantage in screening people who are identified as high risk for developing diabetes. High risk can mean having a first-degree relative with diabetes, being overweight, having polycystic ovarian syndrome, etc.

Researchers have said that this test can identify around half of the people who will go on to develop type 2 diabetes. The test works by detecting a genetic molecule in the blood. 

The same molecule called a microRNA, also appears to be able to help identify patients at high risk of heart and artery disease. It can also help identify which patients who have diabetes are most likely to develop complications. Being able to identify patients with exceptionally high risk for cardiovascular disease will allow health care professionals to treat these patients more aggressively with lipid lowering agents, weight control programs, etc. 

This is an exciting breakthrough and I will keep you updated when the test become available to all of us!