Different types of diabetes
- Neonatal diabetes is diagnosed at less than six months of age and mutations in at least 22 genes are known to cause neonatal diabetes. As mentioned previously all patients with diabetes diagnosed at less than six months of age (whatever their age now) should be referred for genetic testing as they are highly likely to have a monogenic cause of their diabetes.
- Maturity onset diabetes of the young (MODY) is characterised by three key features:
- a young age of onset (at least one family member diagnosed below the age of 25 years)
- autosomal dominant inheritance (diabetes passed down from an affected parent to their child, with diabetes in 2 or more generations
- non insulin dependent diabetes (or evidence of endogenous insulin production more than 3 years post diagnosis).
- GCK (Glucokinase) MODY: Mild hyperglycaemia, fasting blood glucose 5.5-8mmol/l, HbA1c 40-60mmol/mol or 5.8-7.6%), often detected during routine screening, no treatment needed, reduced risk of complications.
- HNF1A MODY: Diabetes often develops during adolescence, sensitive to low dose sulphonylureas, have a low renal threshold for glucose, at risk of diabetic complications, early myocardial infarction.
- HNF4A MODY: Macrosomia and neonatal hypoglycaemia may be present, sensitive to low dose sulphonylureas.
- HNF1B MODY: Diabetes and renal cysts, low faecal elastase, low magnesium, usually require insulin treatment, may have uterine abnormalities or gout.
Genomic Medicine: Transforming Patient Care in Diabetes

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