Introduction: The most common type of diabetes in childhood is type-1 diabetes. The group of diabetes called MODY (maturity-onset diabetes of the young) is rarer. Mutations that occur in glucokinase gene cause disruption in the perception of the resultant glucose level and, consequently, impaired insulin release, leading to the development of MODY-2. In this case, resulting hyperglycemia is usually at a mild, non-progressive level and does not require insulin therapy. For this reason, medical treatment is rarely recommended for the patients. In our clinic, we performed continuous glucose monitoring (CGM) in MODY-2 patients who were diagnosed by genetic analysis. With this study, we aim to reveal the presence of hyperglycaemic periods in a day.
Method: CGM was performed for 6 days in 8 patients who were followed up in Erciyes University Pediatric Endocrinology Clinic and identified mutation related to MODY-2 in GCK gene. The attending symptoms, the age of diagnosis, and the laboratory values were recorded.
Findings: Four of the patients were female and four were male. Two of the patients were admitted to the hospital with complaints of drinking too much water and frequent urination, while 2 were admitted with stress-induced hyperglycemia. The other four patients were initially not symptomatic and hyperglycemia was detected on screening tests for different reasons. At least one of the parents of all patients had blood glucose levels above normal ranges. The mean age of the patients at the time of diagnosis was 10.4 (2.8117.08). The laboratory evaluation at the time of diagnosis and during CGM are summarized in Table 1. Two of the patients initially received short-course insulin treatment and none were using insulin at the time of the evaluation.
Conclusion: Patients diagnosed with MODY-2 may be either symptomatic or asymptomatic at the beginning. Although the HbA1c values of the patients were generally below 7.5, all patients showed a glucose elevation of about 50% and a high blood sugar value of 0.13% in relation to lifestyle and nutritional status. As can be seen from these patients, as long as they do not obey certain rules, they will not develop symptoms during the day but will have high sugar levels that can cause damage in the future similar to that caused by other types of diabetes. We think that continuous glucose monitoring may be useful for awareness and reminding the importance of lifestyle change.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology