Monogenic Diabetes: New Implications(Medical Horizons)

Aly A. Misha'l

Abstract


Classification of Diabetes Mellitus includes Type1, which is an autoimmune disorder resulting in destruction of β-cells of the pancreas, and Type 2 which accounts for approximately 90% of cases. Type 2 diabetes is a heterogeneous metabolic disorder in which the heritability is based on poligencity. Several genetic loci interact with predisposing environmental factors related to lifestyle and diet, to produce this entity which reached epidemic proportions worldwide, and was reported also in the pediatric and adolescent populations.

Over the past decade, many studies have reported infants, children, adolescents and young adults with diabetes that does not fit the above classification. Such individuals have many features of type 2 DM, but with the lack of precipitating environmental lifestyle or dietary factors. Molecular studies revealed specific genetic abnormalities in those young individuals, and hence the term (Monogenic) diabetes came to recognition, in contrast to the usual (polygenic) diabetes which is well known in type 2 DM.

This new knowledge is important in the management of diabetes in young age groups. Many practitioners used to treat them as type1 DM with Insulin therapy, but have encountered unexpected outcomes that could not be explained until recently.

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