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Clinical Heterogeneity in Monogenic Diabetes Caused by Mutations in the Glucokinase Gene (GCK-MODY). Export

Diabetes care (10 November 2009)

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Objective: To evaluate the heterogeneity in the clinical expression in a family with GCK-MODY. Research design and methods: Members (three generations) of the same family presented either with overt neonatal hyperglycemia, marked postprandial hyperglycemia or glucosuria. HOMA(IR), insulinogenic and disposition indices were calculated. OGTT results in the glucokinase(GCK)-mutation carriers from this family were compared with those from other subjects with GCK mutations in the same codon (GCK(261)), with other missense and other types of GCK mutations in different codons from the European-MODY-Consortium database (GCK(m)). Results: Mutation G261R was found in the glucokinase gene. During OGTT, glucose (p=0.02) and insulin (p=0.009) response at 2-hours as well as 2h glucose increment (GCK(261) vs. other missense GCK-mutations, p=0.003) were significantly higher in GCK(261) than in GCK(m) carriers. Conclusions: Differing from other GCK(m) carriers, the glucose and insulin response to oral glucose was significantly higher in GCK(261) carriers indicating clinical heterogeneity in GCK-MODY.


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