Maturity onset diabetes of young type 2 due to a novel de novo GKC mutation

Arq Bras Endocrinol Metabol. 2014 Oct;58(7):772-5. doi: 10.1590/0004-2730000003147.

Abstract

Maturity Onset Diabetes of Young (MODY) is a heterogeneous group of monogenic disorders that result in β-cell dysfunction, with an estimated prevalence of 1%-2% in industrialized countries. MODY generally occurs in non-obese patients with negative autoantibodies presenting with mild to moderate hyperglycemia. The clinical features of the patients are heterogeneous, depending on the different genetic subtypes. We pretend to report a case of MODY type 2 caused by a novel de novo CGK mutation, highlighting the importance of the differential diagnosis in pediatric diabetes. A 13-year-old, healthy and non-obese girl was admitted for investigation of recurrent hyperglycemia episodes. She presented with persistent high levels of fasting blood glycemia (> 11.1 mmol/L) and had no familial history of diabetes. The blood glucose profile revealed an impaired fasting glucose of 124 mg/dL (6,9 mmol/L) with a normal oral glucose tolerance test. Fasting insulinemia was 15 mg/dL (90.1 pmol/L), HOMA-IR was 3.9 and hemoglobin A1c was 7.1%. Pancreatic autoantibodies were negative. Genetic testing identified a novel missense heterozygous mutation in exon 5 of GCK gene c.509G > T (p.Gly170Val), not present on the parents. This result established the diagnosis of MODY type 2. Clinical identification of patients with MODY remains a diagnostic challenge, especially when familial history is absent. Molecular diagnosis is very important for establishing an individualized treatment and providing a long term prognosis for each type of MODY.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / genetics
  • Diagnosis, Differential
  • Fasting
  • Female
  • Genetic Testing
  • Glucokinase / genetics*
  • Heterozygote
  • Humans
  • Hyperglycemia / blood
  • Insulin / blood
  • Mutation, Missense / genetics*

Substances

  • Blood Glucose
  • Insulin
  • Glucokinase

Supplementary concepts

  • Maturity-Onset Diabetes of the Young, Type 2