Diabetes, Genetics and Shidduchim

It’s time for Part X in a series on dating and marriage in the religious Zionist community.

diabetes medical kit Last week’s edition of Torah Tidbits contained an article entitled “Diabetics and Shidduchim” by the Puah Institute for Fertility and Gynecology in Halacha. The article strongly discourages marriage to a person with diabetes. [Edited to add: As Rabbi Weitzman points out, the article doesn’t say what to do. However,  I read the article as strongly discouraging such a marriage.]

After pointing out the difficulties of living with someone who has a serious chronic illness, the author continues:

“. . . one of the risk factors for getting diabetes is that it is hereditary. Therefore someone who has diabetes is likely to pass it on to at least some of his offspring.”

The friend who sent me the article has a child with diabetes. She felt that the attitude in the article could destroy her daughter’s chances of finding a shidduch.

And the author is wrong about the risks. Passing on diabetes to your children is not “likely” at all.

The rest of the article explains how difficult it is for a children to live with diabetes, and for the entire family. The implication is that marrying someone with diabetes will cause suffering for your future children.

But what are the facts? According to Genetics of Diabetes from the American Diabetes Association website:

Risk of Passing on Type 1 Diabetes (formerly known as juvenile diabetes):

. . . . In general, if you are a man with type 1 diabetes, the odds of your child getting diabetes are 1 in 17. If you are a woman with type 1 diabetes and your child was born before you were 25, your child’s risk is 1 in 25; if your child was born after you turned 25, your child’s risk is 1 in 100.

Your child’s risk is doubled if you developed diabetes before age 11. If both you and your partner have type 1 diabetes, the risk is between 1 in 10 and 1 in 4.

There is an exception to these numbers. About 1 in every 7 people with type 1 diabetes has a condition called type 2 polyglandular autoimmune syndrome.

In addition to having diabetes, these people also have thyroid disease and a poorly working adrenal gland. Some also have other immune system disorders. If you have this syndrome, your child’s risk of getting the syndrome including type 1 diabetes is 1 in 2.

The article also notes, “In most cases of type 1 diabetes, people need to inherit risk factors from both parents.” The gene is recessive, so one can carry the gene without being sick.

Risk of Passing on Type 2 Diabetes:

Type 2 diabetes runs in families. In part, this tendency is due to children learning bad habits eating a poor diet, not exercising–from their parents. But there is also a genetic basis.

In general, if you have type 2 diabetes, the risk of your child getting diabetes is 1 in 7 if you were diagnosed before age 50 and 1 in 13 if you were diagnosed after age 50.

Some scientists believe that a child’s risk is greater when the parent with type 2 diabetes is the mother. If both you and your partner have type 2 diabetes, your child’s risk is about 1 in 2.

The Torah Tidbits article doesn’t distinguish between Type 1 and Type 2, although most cases of Type 2 are diagnosed after a woman is past child-bearing age. It might be an issue for younger women dating older men. The significant risk factor for passing on Type I, polyglandular autoimmune syndrome, is also not mentioned.

It’s legitimate to consider medical history when choosing a marriage partner. But exaggerating risks is unethical and counter-productive. Just as with Tay-Sachs, the worst thing is when diabetics can only marry each other, seriously increasing the risk of passing on the illness to their children.

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Comments

  1. Sorry, anyone who takes any kind advice, marriage, health or otherwise, from Torah Tidbits, deserves what they get.

    Shame on all of them.

  2. The TT article really makes me angry. Thank you for bringing out the truth. What is next? Banning children whose mothers had breast cancer?

  3. It’s not TT, Abbi, it’s Machon Puah, and many people take advice from there on even more serious matters.

  4. Sad. Terribly sad. The person becomes their disease, instead of it just being one part of their being. I think of some of the people I know with diabetes, and it is amazing how much they have accomplished. All these people are married with multiple children (and in one case, grandchildren). This thinking is warped.

  5. Errikkaa says:

    That’s really sad. Infertility is a serious issue that Machon Puah is known for helping so many couples overcome in a halachically acceptable way. IMO, they should stick to helping people.

  6. Outrageous! Show me a family that doesn’t have SOMETHING: cancer, heart problems, autism, to short, to tall, to fat, anorexia, or a crazy aunt Linda that noone really speaks of.

    I know Machon Puah is a highly respected organization, but it is hard for me to accept this. It is hard enough to marry off children without some respected organization giving everyone with any kind of “condition” grief.

    And maybe Torah Tidbits itself didn’t give the advice, but by printing it without a disclaimer, they sanctioned it.

  7. I’m in agreement with all the comments to date. Baila has a point about TT’s silent sanction of the Machon Puah advice. Makes me wonder how many people in the offices of Machon Puah (and the Israel Center) have family with one chronic ailment or another – how could they dispense such nonsense?

  8. The article strongly discourages marriage to a person with diabetes.

    They must have a new version of Torah that says Peru Urevu only if you are a perfect specimen of human. I could make a very nasty comment here, but I won’t.

  9. Outside of the frum world completely, my mom feels (or did at one time) that Type 1 diabetics should not have children, ever, the end. I was completely floored when she said that. Because like Baila said, nobody has a perfect genetic record going for them…maybe diabetes is just more obvious?

    Anyway, I have a cousin who got a type 1 dx at age 22–he’s now 28 and marrying another type 1 diabetic. (And changing his whole career path; he took baccalaureate classes and will be going to med school to become an endocrinologist.) I am relatively sure they will elect to have children–but who can deal with the risks and issues better than people who have lived it themselves?

  10. Nurse Yachne says:

    If you want to know what real, cutting-edge medical experts have to say about diabetics, shidduchim, and family life, talk to Dr Weiss or Dr.Gillis in pediatric endocrinology at Hadassah Ein Kerem. They are a lot more positive, in addition to having the scientific goods.

  11. In all cases of people with illnesses, disabilities, mental illnesses etc. each individual has to decide for himself whether a shidduch with such a person is appropriate for him/her. There isn’t one answer.

  12. JID–of course you’re right. But when an organization such as Machon Puah makes a statement like that it can be very damaging.

  13. observer says:

    It strikes me that before anyone starts jumping up and down, it may pay to find out what Machon Puah’s actual stance is. It could be that they really do have such a policy. On the other hand, I would not be surprised if TT edited an article to get these results. Of course if that’s the case, Puah should have caught the problem, but I could see how something like that might slip, if they are not familiar enough with the publication.

  14. Baila – You are totally right. If Machon Puah did in fact make an across-the-board statement it can be very damaging.

  15. observer says:

    I actually emailed Puah to ask them about their stand on diabetes and Shiduchim. This is the full and unedited text of the response they sent me:

    Shalom U’verachah,

    I received your question about shidduchim with diabetes. I would definitely NOT say that one should not make a shidduch with someone who has diabetes, only that this is relevant information.

    As I wrote, in most cases this can be dealt with through the proper lifestyle and medication and should not hinder having a full and active life.

    I suggest practically that each case needs to be examined individually.

    Kol Tuv

    Rabbi Gideon Weitzman
    Director
    Puah Institute
    http://www.puahonline.org

    http://www.puah.org.il

    questions@puah.org.il

  16. Sheinpt says:

    Its a shame that Rabbi Weitzman didn’t address his position on the “fact” that diabetes is hereditary and that subsequent children of such a marriage are in great danger of contracting the disease! I have spoken to a top diabetic specialist at schneider and a formal response from there is being penned, but I was told that Diabetes is NOT hereditary and the risk of a mother passing it on to her children is only 4-5% over that of a non diabetic mother!

  17. Gideon Weitzman says:

    I appreciate a reaser alerting me to this discussion. I have just reread my article that I sent to Torah Tidbits and I do not see a strng suggestion, or any suggestion not to marry a person with diabetes. It is possible that it was edited without my knowledge.

    As I have written many times the idea of the column is to raise awareness to the questions, and not to give specific halachic advise.

    I appreciate all comments and questions at my email, questions@puah.org.il

  18. good for you for putting this out there! what a shame to have mis-information billed as helpful advice! like others above, i’m saddened by the obvious judge-iness factor.

  19. Since every family has some medical issue, maybe no one should be getting married?
    Or, maybe everybody should just marry whoever he or she deems fit, and ignore all the bad advice out there.

Trackbacks

  1. […] A Mother in Israel continues her series about dating and marriage with Diabetes, Genetics, and Shidduchim. […]

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