Endocrine Abstracts

Introduction

The aim of this study, which was conducted for the first time in Ukraine, was to analyze a glycemic control in patients with different types of diabetes mellitus (DM), including neonatal (ND) and maturity onset diabetes of the young (MODY) and changing their treatment after the results of genetic testing.

Materials and methods

The Ukrainian Pediatric Diabetes Register was established in 2002 and included 9471 children with type 1 DM (a prevalence of 1 in 800 for the pediatric population), 47 children with type 2 DM (a prevalence of 1 in 161270), 65 patients with ND (a prevalence of 1 in 116610) and 48 patients with MODY (a prevalence of 1 in 157910) in 2019y. We analyzed the glycemic control in patients depending on the type of DM, namely: type 1 DM (n = 9471), type 2 DM (n = 47). HbA1c was analyzed also in patients with ND (n = 16) with KCNJ11 and ABCC8 variants and MODY (n = 16) with HNF1A/HNF4A and ABCC8 variants before genetic testing and after 3 and 12 months of sulfonylurea (SU) treatment. To confirm the nature of ND and MODY, targeting next-generation sequencing (tNGS) of all known neonatal and monogenic diabetes genes was performed.

Results

According to the Register in 2019, in Ukraine the average age of children with type 1 DM was 11.5 ± 1.4 years, and the level of HbA1c was unsatisfactory (8.8v2.01%). The proportion of children who had ideal or optimal glycemic control (HbA1c < 7.5%) was the smallest (28.15%). The Register included also 47 children with type 2 DM with an average age of 16.2 [15.5; 18] years old and HbA1c level 6.7 [5.7; 7.9]%. All patients with ND and MODY with confirmed mutations in KCNJ11, ABCC8 and HNF1A/HNF4A genes and unsatisfactory glycemic control discontinued insulin therapy (or other inappropriate treatment) and were transferred to SU, which lead to the significant improvement in glycemic control (decreasing of HbA1c level) after 3 months and 12 months of SU treatment (P < 0.05).

Conclusions

The glycemic control in patients with type 1 DM in Ukraine was unsatisfactory compared to ND and MODY patients with mutations in KCNJ11, ABCC8 and HNF1A/HNF4A genes, who received pathogenetically justified treatment with SU drugs, as well as in type 2 DM patients.