Endocrine Abstracts

Most young patients with hyperglycemia are diagnosed with type 1 diabetes mellitus and type 2 diabetes mellitus (T2DM) but up to 10% of all cases of the disease occur in MODY diabetes. Diagnosis of the correct type of diabetes mellitus (DM) leads to the appointment of pathogenetic effective therapy, adequate management of pregnancy and the prevention of specific complications. The aim of the study was to create a model for the differential diagnosis of T2DM and MODY.

Materials and methods: We examined 108 people in Novosibirsk city who had debut of DM up to 35 years: 92 patients has been confirmed by molecular – genetic testing MODY, 91 – type 2. All patients had a clinical examination, blood sampling for biochemical and hormone (TSH, C-peptide) analyzes. A model was constructed to study the most significant factors during the diagnosis of type of diabetes using binary logistic regression.

Results: Both groups of patients were comparable in gender, age, and duration of diabetes. Median of age of the patients at moment of examination was with T2DM – 29.5 [17.7;37.0] years, with MODY – 24.0 [0.0;35.0] years (P = 0.280). After creating various regression models the most significant factors associated with diabetes were identified: ‘the presence of relatives with diagnosed diabetes for them under 35 years of age’, ‘the presence of relatives with impaired carbohydrate metabolism and obesity’, ‘overweight and obesity’. A final regression model is constructed to determine the significance of these factors. Among the analyzed factors associated with the type of diabetes all three were statistically significant (P < 0.001).

Thus when studying the influence of a hereditary history, clinical and laboratory factors in MODY and T2DM during the construction of binary regression models it was determined that the presence of relatives with verification of hyperglycemia up to 35 years was associated with MODY diabetes and the presence of excess weight and obesity in patients with T2DM as well as relatives with diabetes and obesity. These results should be taken into account when conducting differential diagnosis of the type of diabetes mellitus in individuals with diagnosed hyperglycemia up to 35 years.