What is monogenic diabetes?

Dr Andrew Jamieson MB ChB(Hons) BSc(Hons) PhD MRCP(UK) FRCPGlasg AFHEA Consultant Physician and Endocrinologist Honorary Senior Lecturer in Medicine, University of Glasgow GCAA Accredited Specialist Aeromedical Examiner

Have you heard of Monogenic Diabetes? The vast majority of people with diabetes have either Type 1 or Type 2, so most of the information that’s out there focuses on these common types of diabetes. We wanted to explore this lesser-known type of diabetes, so we asked an expert.

Here’s what Dr Andrew Jamieson, Consultant Physician and Endocrinologist, told us about Monogenic Diabetes. This gave us a much better understanding about it and we hope it helps you too.

What is Monogenic Diabetes? Is it like Type 1 or Type 2 Diabetes?

Monogenic Diabetes is also known as MODY (Maturity Onset Diabetes of the Young).

It refers to those cases of diabetes which result from very specific alterations in a single gene. It can appear at any age and there is usually a strong family history of diabetes affecting both males and females.

Unlike Type 1 or Type 2 Diabetes, a DNA test can be used to confirm the diagnosis in anyone who is potentially affected.

What causes Monogenic Diabetes?

We know that in both Type 1 and Type 2 Diabetes, there is a hereditary factor that increases the likelihood of a parent who has diabetes passing on the condition to their children.

In Monogenic Diabetes we can be very specific about the level of risk of a child inheriting the condition. Once the abnormal gene is detected, we can test individuals and say with certainty whether they have the gene or not.

There are a number of different types of Monogenic Diabetes and one gene defect gives rise to one type. There are at least 13 genes that can be tested for alterations giving rise to Monogenic Diabetes, and the clinical features can often guide the clinician to make an educated guess as to which genes are more likely to be implicated, therefore helping to target the testing to the correct genes.

How is Monogenic Diabetes diagnosed?

Many people with Monogenic Diabetes are known to have diabetes and have been labelled as Type 1 or Type 2 for many years before their diagnosis is corrected.

There are a few helpful hints that can help correctly diagnose someone with Monogenic Diabetes:

  • Diagnosis of Type 1 Diabetes before the age of 6 months
  • Delay in the need for insulin for longer than 6 months after initial diagnosis of diabetes
  • Multiple family members of both sexes with diabetes
  • Young onset of diabetes in multiple family members.

Once Monogenic Diabetes is suspected, there are a few tests that can help further:

  • C-peptide measurement (a substance that is secreted in the body in equal concentration to insulin. This test can help to determine how much natural insulin a person is producing)
  • Using an online risk calculator.

How is Monogenic Diabetes treated?

Depending on the type of Monogenic Diabetes, the person may require no treatment at all. Or they may be adequately treated for many years with low doses of sulphonylurea drugs and avoid the potential for developing complications.

Does someone with Monogenic Diabetes need to follow a special diet?

Everyone with diabetes can aim to have the healthiest possible diet and exercise regime, regardless of what the underlying cause of their diabetes is.

Can people with Monogenic Diabetes live normal, healthy lives?

Absolutely! Often with fewer problems than people with Type 1 or Type 2 Diabetes.

Do you have other questions about MODY or Monogenic Diabetes? Ask us in the comments below and we will try to help you find the answer.


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