GCK-MODY in the US National Monogenic Diabetes Registry: frequently misdiagnosed and unnecessarily treated
Open accessAbstract
Aims GCK-MODY leads to mildly elevated blood glucose typically not requiring therapy. It has been described in all ethnicities, but mainly in Caucasian Europeans. Here we describe our US cohort of GCK-MODY. Methods We examined the rates of detection of heterozygous mutations in the GCK gene in individuals referred to the US Monogenic Diabetes Registry with a phenotype consistent with GCK-MODY. We also assessed referral patterns, treatment and demography, including ethnicity, of the cohort. Results Deleterious heterozygous GCK mutations were found in 54.7 % of Registry probands selected for GCK sequencing for this study. Forty-nine percent were previously unnecessarily treated with glucose-lowering agents, causing hypoglycemia and other adverse effects in some of the subjects. The proportion of probands found to have a GCK mutation through research-based testing was similar across each ethnic group. However, together African-American, Latino and Asian subjects represented only 20.5 % of screened probands and 17.2 % of those with GCK-MODY, despite higher overall diabetes prevalence in these groups. Conclusions Our data show that a high detection rate of GCK-MODY is possible based on clinical phenotype and that prior to genetic diagnosis, a large percentage are inappropriately treated with glucose-lowering therapies. We also find low minority representation in our Registry, which may be due to disparities in diagnostic diabetes genetic testing and is an area needing further investigation.
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Atypical diabetes is becoming increasingly difficult to precisely define in the absence of a definitive set of tests for either type 1 or type 2 diabetes.
“although admittedly, atypical diabetes is becoming increasingly dif fi cult to precisely de fi ne in the absence of a de fi nitive set of tests for either type of diabetes (158 -160,163 -169)”
From 2. Diagnosis and Classification of Diabetes: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [159]
The Introduction (page unavailable) says GCK-MODY is misdiagnosed as type 1 or type 2 diabetes, and the Discussion says misdiagnosis is frequent. The paper does not say that atypical diabetes is becoming increasingly difficult to define or that this difficulty stems from a lack of definitive tests for type 1 and type 2 diabetes. (LLM, conf=0.80)
Experimental — accuracy not yet measuredDiabetes occurring under 6 months of age is termed neonatal or congenital diabetes, and about 80-85% of cases can be found to have an underlying monogenic cause.
“Diabetes occurring under 6 months of age is termed neonatal or congenital diabetes, and about 80 -85% of cases can be found to have an underlying monogenic cause (36,157 -160).”
From 2. Diagnosis and Classification of Diabetes: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [159]
The Discussion addresses genetic testing and underrecognition of GCK-MODY, not the definition or prevalence of monogenic neonatal diabetes. Searches for diabetes before six months and for an 80–85% monogenic cause found no passage in our copy supporting either part of the claim. (LLM, conf=0.76)
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- Authors
- Carmody, D., Naylor, R. N., Bell, C. D., Berry, S., Montgomery, J. T., Tadie, E. C., Hwang, J. L., Greeley, S. A. W., & Philipson, L. H.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Naylor, Rochelle N.
- ORCID
- Venue
- Acta Diabetologica
- Published
- 2016-04-22
- Volume
- 53
- Issue
- 5
- Pages
- 703-708
- ISSN
- 0940-5429 (ISSN-L)
- 1432-5233
- PMC
- PMC5016218
- OpenAlex
- W2339522457
- Cited by
- 84
- References
- 36
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 11 · 2021: 13 · 2020: 7 · 2019: 11 · 2018: 9 · 2017: 5 · 2016: 1
- FWCI
- 7.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Acta Diabetologica (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Diabetes Association (1-11-CT-41)
- National Institutes of Health (P30DK020595, UL1RR024999, K23DK094866, K12-HS023007-01)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Keywords
- GCK-MODY, monogenic diabetes, misdiagnosis, hypoglycemia, minority representation, genetic testing, diabetes registry
- MeSH terms
- Adolescent, Adult, Child, Diabetes Mellitus, Type 2, Diagnosis, Differential, Female, Glucokinase, Humans, Male, Middle Aged, Mutation, Phenotype, Registries, United States, Selection Bias
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