Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2019; 10(10): 511-516
Published online Oct 15, 2019. doi: 10.4239/wjd.v10.i10.511
Type 1 diabetes in a Nigerian family - occurrence in three out of four siblings: A case report
Michael Adeyemi Olamoyegun, Oluwabukola Ayodele Ala
Michael Adeyemi Olamoyegun, Department of Internal Medicine, Endocrinology, Diabetes & Metabolism Unit, College of Health Sciences, Ladoke Akintola University of Technology (LAUTECH)/LAUTECH Teaching Hospital, Ogbomoso 240222, Oyo State, Nigeria
Oluwabukola Ayodele Ala, Department of Internal Medicine, Endocrinology, Diabetes & Metabolism Unit, BOWEN University Teaching Hospital, and College of Health Sciences, BOWEN University, Iwo 232101, Osun State, Nigeria
Author contributions: Olamoyegun MA conceived, designed and wrote the manuscript; Ala OA critically reviewed the manuscript and made significant contributions; Both authors approved the final draft and submission.
Informed consent statement: Not necessary in our country.
Conflict-of-interest statement: The authors have declared no conflicts of interest.
CARE Checklist (2016) statement: The authors have checked the manuscript according to the checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Michael Adeyemi Olamoyegun, FACE, FACP, MBBS, MSc, Academic Fellow, Lecturer, Senior Lecturer, Department of Internal Medicine, Endocrinology, Diabetes & Metabolism Unit, College of Health Sciences, Ladoke Akintola University of Technology (LAUTECH)/LAUTECH Teaching Hospital, Ogbomoso 240222, Oyo State, Nigeria. maolamoyegun@lautech.edu.ng
Telephone: +234-8-035755239
Received: June 27, 2019
Peer-review started: June 29, 2019
First decision: August 2, 2019
Revised: September 4, 2019
Accepted: September 22, 2019
Article in press: September 22, 2019
Published online: October 15, 2019
Processing time: 110 Days and 8.8 Hours
Abstract
BACKGROUND

Most occurrences of type 1 diabetes cases in any population are sporadic rather than familial. Hence, type 1 diabetes among siblings is a rare occurrence. Even more rare is for three or more siblings to develop type 1 diabetes. In this report, we describe a case of a Nigerian family in which type 1 diabetes occurred in three siblings among four children with neither parent having diabetes. All three siblings are positive for glutamic acid decarboxylase and anti-islet cell antibodies.

CASE SUMMARY

There were four siblings (three males and one female) born to a couple without a diagnosis of diabetes. The eldest child (male) was diagnosed with diabetes at the age of 15, the second child (female) was diagnosed at the age of 11 and the fourth child (male) was diagnosed at the age of 9. All the siblings presented with similar osmotic symptoms and were diagnosed of diabetic ketoacidosis. All of them had markedly reduced serum C-peptide levels with high levels of glutamic acid decarboxylase and insulinoma-associated protein-2 antibodies. We could not perform genetic analysis of HLA-DR, DQ and CTLA4 in the siblings as well as the parents; hence haplotypes could not be characterized. Both parents of the probands have no prior history of diabetes, and their blood glucose and glycated hemoglobin levels were within normal ranges. The third child (male) has no history suggestive of diabetes, and his blood glucose and glycated hemoglobin have remained within normal ranges.

CONCLUSION

Although the occurrence of type 1 diabetes in proband siblings is uncommon, screening for diabetes among siblings especially with islet autoantibodies should be encouraged.

Keywords: Type 1 diabetes; Siblings; Case report; Nigerian; Family

Core tip: Although most occurrences of type 1 diabetes are sporadic, it can also be familial. Type 1 diabetes among siblings is a rare occurrence. Even more rare is for three or more siblings to develop type 1 diabetes. Hence due to the possibility of this familial occurrence, screening for diabetes among siblings should be encouraged. This report describes a case of a Nigerian family in which type 1 diabetes occurred in three siblings among four children with neither parent having diabetes.