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Question:

From Homestead, Florida, USA:

My 14 year old daughter has been diagnosed as having either MODY or the onset of Type 1. She is under the care of an endocrinologist, and is tested every 12 weeks for antibodies. She was on Precose (a diabetes pill usually used for treatment of Type 2 diabetes), but is now able to control with diet and exercise. She is not overweight. There is a family history of Type 2, but never in anyone under 40. I understand that there is a genetic link to MODY, and can be one of 3 different types. Should I have her genetically tested? Would this be beneficial in treating her long term?

Answer:

Unless she is of Hispanic or African American descent, the great majority of 14 year olds who develop diabetes in the US have Type 1A or autoimmune diabetes. If however, at this stage your daughter's antibody test is negative, then she does not have this form of the disorder. In those cases where there is a typical acute onset very much like Type 1A Diabetes, the term Type 1B is now coming to be used. The importance of this designation is that many of these children, despite the acute onset, can manage without insulin after a few weeks and blood sugars can be controlled by diet, exercise and sometimes oral hypoglycemic drugs as well.

Because your daughter had a very mild onset, I suspect that she is indeed a case of MODY (Maturity Onset Diabetes in the Young). Precise diagnosis has unfortunately become a rather complex process. There are now four recognised main types of MODY, and in the commonest which is MODY2 or glucokinase deficiency, there are also many variants. At the moment there is no central laboratory that will undertake these very specialised tests. From a clinical point of view, however, this not particularly important because an exact genetic definition does not affect treatment and in the very great majority of this small group the chance of long term vascular complications is significantly diminished.

DO'B

Original posting 4 Oct 1998
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:00
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