Simultaneous onset and similar course of type 1 diabetes mellitus in monozygotic twins (a 4-year follow-up)

Abstract

We report a rare case of monozygotic (MZ) twins who developed simultaneous onset of type 1 diabetes mellitus (T1DM). Laboratory fi nding showed similar values of blood sugar, pH, glycosylated hemoglobin, and C-peptide. Urinary sugar and ketones were detected in both. Endocrine and immunological assessment showed similar results. No evidence (clinical or serological) of recent viral or bacterial infection was found. In the 4 years of follow-up, the twins also showed a similar course of disease. Concordance rates for T1DM are high in MZ twins; nevertheless, a simultaneous onset and a similar course of disease are unusual, as well as the HLA allelic variants of our patients. This extraordinary concordance in a pair of MZ twins could be the consequence of a greater environmental similarity or the role of genetic factors other than HLA genes in our twins.

Twins and endocrinology

“…[ 20 ] The risk of developing T1DM is influenced by the age of the onset in the first twin, and the concordance was increased in twins who were heterozygous for human leukocyte antigen DR3-DQ2 and DR4-DQ8. [ 21 ] These data suggest that genetics plays an important role in the development, severity and progression of T1DM. Sex differences have also been observed in twin studies on diabetes mellitus.…”