monogenic diabetes Flashcards

1
Q

what is monogenic diabetes?

A

-diabetes caused by a mutation in a single gene

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2
Q

whats another name for monogenic diabetes?

A

mendelian diabetes

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3
Q

is monogenic diabetes autosomal dominant or recessive?

A

-can be either

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4
Q

what is the most common for of monogenic diabetes?

A

MODY

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5
Q

what is a common feature of monogenic insulin resistence?

A
  • ancanthosis nigricans (seen in hyperinsulinemic states) caused by insulin driven epithelial overgrowth
  • lypodystrophy (problem in the way the body stores and uses the fat)
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6
Q

what is a common feature of monogenic insulin resistence?

A
  • ancanthosis nigricans (seen in hyperinsulinemic states) caused by insulin driven epithelial overgrowth
  • lypodystrophy (problem in the way the body stores and uses the fat)
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7
Q

what type of inheritence is MODY (maturity onset of diabetes of the young)?

A

-autosomal dominant inheritence

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8
Q

is MODY insulin requiring diabetes?

A

no like type 2

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9
Q

what is the usual onset for MODY?

A

<25

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10
Q

what determines the phenotype defect in MODY?

A

which gene is affected- there are 11 genes

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11
Q

what are some of the most common MODY defects?

A
  • defects in mitochondrial metabolism e.g. Krebs cycle (transcription factor MODY)
  • defects in glucokinase (the rate limiting factor of glycolysis) and hence affecting glycolysis
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12
Q

how does blood glucose levels change for someone with transcription factor MODY ?

A

-Transcription factor MODY will have normal glucose in early childhood and then in teenage/early adulthood there is a quick rise in blood glucose

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13
Q

how does blood glucose levels change for someone with glucokinase MODY ?

A

-they have a high fasting glucose from birth and then it raises gradually over time

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14
Q

what would an oral glucose tolerance test results look like for someone with a glucokinase MODY?

A
  • normal fasting glucose

- because able to respond well to oral glucose and can produce lots of insulin they bring their glucose down very well

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15
Q

what would an oral glucose tolerance test results look like for someone with a transcription factor mutation MODY?

A
  • theyre fasting glucose will be high

- once given glucose theyre glucose will go sky high and struggle to lower back to normal (blue line)

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16
Q

what are the 2 mutations MODY can mainly be split into?

A
  • glucokinase mutations

- transcription factor mutations

17
Q

what is the onset for glucokinase MODY ?

A

birth

18
Q

what is the onset for transcription factor MODY ?

A

adolescence/ young adult onset

19
Q

what is the treatment for glucokinase MODY?

A

diet treatment

20
Q

what is the treatment for transcription factor MODY?

A

1/3 diet
1/3 OHA
1/3 insulin

21
Q

are complications more common in glucokinase MODY or transcription factor MODY?

A

-transcription factor mody

theyre rare in glucokinase mutation

22
Q

how much more sensitive are patients with HNF-1A mody to sulphanylureas than patients with T2DM?

A

4 times

23
Q

treatment for HNF1A mody? (transcription factor mutation)

A

can transition off insulin on to low dose sulphonylureas

24
Q

treatment for KCNJ11/ABCC8 neonatal diabetes?

A

can transition off insulin onto high dose sulphonylureas