Damocles was a courtier in the court of Dionysius II of Syracuse in 4^th century BC. Unfortunately, Damocles, trying to curry favor, complemented Dionysius by noting that as a "great man of power, he was extremely fortunate." Dionysius offered to trade places with Damocles for a day. In the evening a banquet was held and while Damocles was enjoying the festivities, he noted that a sharpened sword was hanging directly over his head by single horsehair. He immediately lost all interest in the banquet and asked to take immediate leave from the tyrant, Dionysius. (Wikipedia)

Cicero, the great philosopher, understood that this legend conveyed a sense of the constant fear in which the great man lived and asked:

"Does not Dionysius seem to have made it sufficiently clear that there can be nothing happy for the person over whom some fear always looms?" (Cicero, Tusculan Disputations 5.1.)

The "Sword of Damocles" is thus used to denote the sense of foreboding that is triggered by a precarious situation, especially when the onset of tragedy is restrained by a delicate thread.

You are probably asking how the "Prediction of Type 1 Diabetes" relates to the "Sword of Damocles?" The underlying subtext is "Do you want to know the risk of developing type 1 diabetes when at this current time we can do nothing to prevent its development?" ANSWER: It depends. Every family is different. Some families want to know everything and will research every possible source to become fully informed. Others do not wish to know this information for fear of the "knowledge of the possibility" or The Sword of Damocles.

The recent paper in Diabetes Care 33: 1206-1212, 2010: Prediction of Type 1 Diabetes in the General Population addresses the risk of the development of type 1 diabetes in the general population as opposed to first degree relatives. The Finish authors, Knip et. al, evaluated the efficacy of GAD antibodies (GADAs) and islet antigen-2-antibodies (IA-2As) in predicting type 1 diabetes over a 27-year time frame in the general population and determined the 6-year rates of newly developed antibodies. 3,475 nondiabetic subjects (ages 3-18) were sampled for GADA and IA-2A in 1980. 2,375 subjects (68.3%) were retested in 1986. All subjects were observed for the onset of type 1 diabetes until the end of 2007. The results:

1. 34 subjects initially had GADAs. 1% or 9 individuals developed diabetes.
2. 22 subjects initially had IA-2As. 0.6% or 9 individuals developed diabetes.
3. 7 subjects initially had both GADA's and IA-2As. 0.2% or 7 individuals developed diabetes.
4. The positive seroconversion rate over 6 years was 0.4% for GADAs and 0.2% for IA-2As .
5. 18 subjects or 0.5% developed type 1 diabetes after a median of 8.6 years.
6. Initial positivity for GADAs and/or IA-2As had a sensitivity of 61% for type 1 diabetes.
7. Combined positivity for GADAs and IA-2As had both specificity and a positive predictive value of 100%.