A 29 years old person is a known diabetic on oral hypoglycemic agents since 3 years. He has lost weight and never had DKA. His grand father and father both are diabetic. Which of the following is the most likely diagnosis?
Onset of Non Insulin dependent Diabetes at a young age, absence of obesity and DKA and positive family history with evidence of veical transmission of diabetes through two generations (possible autosomal dominant inheritance) suggests the diagnosis of MODY. Diagnostic criteria that help to establish diagnosis of MODY include: Early diagnosis of diabetes - before age 25 years in at least one and ideally two family members. Not insulin-dependent - shown by absence of insulin treatment 5 years after diagnosis or significant C-peptide in a patient on insulin treatment. Autosomal dominant inheritance i.e. veical transmission of diabetes through at least two generations (ideally three generation), with a similar phenotype in cousins or second cousins. Rarely obese (obesity is not required for the development of diabetes) Diabetes results from 3-cell dysfunction (insulin levels are often in the normal range, though inappropriately low for the degree of hyperglycemia). Ref: Current Medical Diagnosis and Treatment, 2007 Page 1222 and 2009, Page 1054; Clinical Endocrinology and Diabetes Mellitus By Sachdev and Gupta 1st Edition, Page 916
MODY
DM type I
DM type II
Pancreatic diabetes