The convergence of type 1 and type 2 diabetes in childhood: the accelerator hypothesis

Pediatr Diabetes. 2012 Jun;13(4):334-9. doi: 10.1111/j.1399-5448.2011.00831.x. Epub 2011 Nov 8.


It seems likely that type 1 and type 2 diabetes lie at different points of the same spectrum, separated by the misunderstanding that one belongs to childhood and the other to adulthood. The spectrum is that of tempo--the rate at which beta cell function is lost over time. A combination of beta cell up-regulation (insulin demand, largely determined by obesity) and the genetically-determined immune response to it ('autoimmunity') determines tempo, ranging from slow to fast with every variant in between. There is good evidence that people who go on to develop type 1 (fast) diabetes are, like those who develop type 2 (slow diabetes), insulin resistant, and overwhelming evidence that body mass plays a key role. The prevention of type 1 diabetes may lie in weight restriction from an early age.

MeSH terms

  • Adult
  • Apoptosis
  • Autoimmunity / immunology
  • Body Mass Index
  • Child
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 2 / immunology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Genetic Predisposition to Disease
  • Humans
  • Insulin / therapeutic use
  • Insulin Resistance / genetics
  • Insulin-Secreting Cells / immunology
  • Insulin-Secreting Cells / pathology
  • Insulin-Secreting Cells / physiology
  • Models, Biological
  • Obesity / complications
  • Obesity / physiopathology


  • Insulin