From Glendale, Arizona, USA:
My daughter's 28 year old fiance, diagnosed about six years ago and on insulin three times a day, was told he did not have either not type 1 or type 2 diabetes. No one else in his immediate or extended family has diabetes. He recently had blood work done and all tests were normal values, including his C-peptide. He is 6 feet 4 inches tall, weighs 180 pounds, and he cannot gain weight. He and his mother take thyroid medication.
Could he have been misdiagnosed? What is the implication for my daughter and her fiance in having children? Is there a correlation between mother's with thyroid problems and their children developing diabetes? Does he really have diabetes?
As physicians who see patients with diabetes, we are having more difficulty characterizing people as having type 1 or type 2 diabetes. The most common group are individuals who are thin, without a family history, but who still have some insulin secretory function. It would seem that your daughter's fiance is probably in this group. The natural history of this group of patients is to go on and have progressive loss of insulin production. This is most likely Late-onset Autoimmune Diabetes of Adulthood (LADA) that is slow to progress from the time it is diagnosed. Type 1 diabetes is also associated with autoimmune thyroid disease and would be consistent in this scenario. Insulin therapy is most appropriate. I would suggest he really does have diabetes.
Future risk of diabetes in children is increased but not as much as if he had type 2 diabetes. The risk for diabetes in the offspring would be roughly 10%.
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