Background: As the human genome is further explored, multiple genetic anomalies at different loci are being found that confer varying degrees of predisposition to diabetes. MODY is the most common form of monogenic diabetes, accounting 25 percent of diabetes. Recently, we have found and reported three noble gene variants relating to MODY in Korean children (Shim et al, Horm Res Pediatr, 2015).
Objective and hypotheses: This study was done to see the frequency of possible monogenic diabetes in Korean children with diabetes mellitus and their clinical and laboratory characteristics.
Method: Study patients consisted of 126 children with diabete mellitus (DM) who visited our institute between 2008 and 2015. Their medical records were reviewed retrospectively. They classified into three groups; type I (T1DM), type II (T2DM) and monogenic diabetes mellitus (MDM) including MODY by the ADA classification of DM. Various clinical and laboratory data was analyzed.
Results: The frequencies were 48 (38%) in T1DM, 42 (33%) in T2DM, and 36 (29%) in possible MDM. Majority of possible MDM was MODY (22 out of 36, 61%). Ages (years) at diagnosis were 9.2±4.1 in T1DM, 13.4±2.4 in T2DM, and 12.3±3.1 in MDM. The age at diagnosis was significantly older in T2DM compared to T1DM (P=0.000). BMI (kg/m2) was significantly higher in T2DM compared to T1DM or MDM, 25.9±4.7 vs 16.9±5.1 vs 19.7±5.1, respectively (P=0.001). Initial fasting insulin levels (IU/ml) were significantly higher in T2DM than T1DM or MDM, 13.01±9.45 vs 2.10±2.68 vs 4.85±5.25, respectively (P=0.000). C-peptide levels (ng/ml) were significantly higher in T2DM compared to T1DM or MDM, 3.19±1.40 vs 0.29±0.15 vs 1.17±0.39, respectively (P=0.000). HbA1c levels (%) were significantly higher in T1DM compared to T2DM, 13.31±3.09 vs 11.22±2.40, respectively (P=0.001).
Conclusions: It appears that possible monogenic diabetes including MODY in Korean children with DM is more prevalent than expected. Further large scaled studies including genes related to monogenic DM are necessary.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology