Title : A diabetic specialist and an unexpected diagnosis: Genetic and environmental influence (post covid) between mother and daughter with T1D
Abstract:
Identification:
- Patient 1 (Mother): A.P.F., female, 38 years old.
- History: Diagnosed with T1D at age 5, 33 years ago.
- Profession: Nurse, PhD in the area of Diabetes.
- Patient 2 (Daughter): C.F, female, 8 years old.
- History: Diagnosed with T1D 2 years ago, at age 6.
- Family History: Mother with T1D since childhood.
History of Present Illness (Patient 1): [Mother A.P.F.] was diagnosed with T1D in 1992, at the age of 5, after presenting the classic symptoms. She has been using intensive insulin therapy and continuous glycemic monitoring. Her experience as a patient motivated her to pursue a career in the health field, dedicating herself to the study and care of people with DM for 17 years.
History of Present Illness (Patient 2): Two years ago, at the age of 6, [C.F.] began to present classic symptoms: excessive thirst and fatigue. The mother, attentive to the signs, began to have “denial” about what she was observing, but on the second day she performed a capillary blood glucose test that revealed HI. In great despair, the mother immediately took her daughter to the hospital for the diagnostic confirmation. The child is on insulin therapy and monitoring and practices self-care very responsibly.
Discussion: The occurrence of T1D in mother and daughter raises the question of genetic predisposition to the disease. Although T1D is not considered a classic hereditary disease, genetics plays an important role in susceptibility. The exact probability of a mother with T1D transmitting the disease to a child is complex and influenced by several genetic and environmental factors. However, we can present a general estimate: 1 and 4%.
Several genes are involved in the susceptibility to T1D, mainly the HLA (Human Leukocyte Antigen) genes located on chromosome 6. The inheritance of these genes can increase or decrease the risk.
The possible influence of post-COVID on the development of T1D is an emerging and relevant research topic. Some studies have suggested a possible association between SARS-CoV-2 infection and an increase in the incidence of new cases of T1D. The exact mechanisms of this relationship are still being investigated, but some hypotheses include:
- Molecular Mimicry,
- Immune Dysfunction
- Direct Damage to Beta Cells.
It is important to emphasize that this is an area of active research and further studies are needed to confirm and elucidate this possible link between COVID-19 and the development of DM1. The tests showed that the child had Covid, and then had an allergic reaction throughout the abdomen, ruling out other causes and previous situations, which led to the second condition being considered. On the other hand, the C-peptide test performed had a practically zero result, which demonstrated a very sudden and strong attack, which suggests the third condition. It is important to emphasize that the child did not reach the stage of Diabetic Ketoacidosis and did not have the honeymoon phase.
Conclusion: This clinical case illustrates the complexity of Type 1 Diabetes Mellitus, with the mother's story showing a life of adaptation, initially as a T1D patient, who had a professional career and as a researcher in the field, and that years later, her daughter faces the same diagnosis at an early age, possibly influenced by a combination of genetic predisposition and, who knows, environmental factors such as a previous viral infection.
