Mody false is -
Ans. is 'd' i.e., Insulin dependent Maturity onset diabetes of the young (MODY) o This is characterized by non-insulin dependent diabetes mellitusQ o The usual age of onset is 25 years or youngerQ o Patients are nonobese and their hyperglycemia is due to impaired glucose induced secretion of insulinQ. o It generally responds well to low doses of oral hypoglycemic agentsQ. Tvpe II diabetes mellitus - o In this type of diabetes obesity, insulin resistance and relative insulin deficiency are key findings. Insulin secretion is usually sufficient to prevent ketosis under basal conditions, o It is common in obese individuals but can occur in non obese too. o The diabetes is usually controlled with oral hypoglycemic agentsQ (insulin is usually not required). So. How to differentiate between MODYand diabetes mellitus type II ???. Diagnostic criteria for the diagnosis of MODY include : o Not insulin-dependent - sho wn by absence of insulin treatment 5 years after diagnosis or significant C-peptide in a patient on insulin treatment. o Rarely obese (obesity is not required for the development of diabetes). o Early diagnosis of diabetes - before age 25 years in at least one and ideally two family members. o Autosomal dominant inheritance i.e. vertical transmission of diabetes through at least two generations (ideally three generation), with a similar phenotype in cousins or second cousins. o Diabetes results from b-cell dysfunction (insulin levels are often in the normal range, though inappropriately low for the degree of hyperglycemia). Type I Type II Mody Age of onset Predominantly young Predominantly middle to old age Predominantly yound (usually < 25 years) Family history Not significant (ucommon) Significant (Positive) Inheritance is Polygenic/Heteroaenous Vertical transmission through successive generations is not essential for diagnosis Signi ficant (Positive) Inheritance is Monoeenic/Autosomal dominant Vertical transmission through at least two successivegeneration (ideally three) is essential for diagnosis Risk of ketoacidosis High Low (uncommon) Low (uncommon ) Insulin dependence Insulin dependent Non insulin dependent Non insulin dependent Obesity Uncommon (may be present) Common (may be absent) Uncommon (may be present) Pathophysiology b cells dysfunction (Autoantibodies against b cells) No insulin resistance bcell dysfunction Insulin resistance b cell dysfunction No insulin resistance Fasting 'C' pcptide/insulin Low High Low
Age <25 years
Impaired secretion of insulin
Responds to sulfonylureas
Insulin dependent
Diabites & Inappropriate Antidiuretic Hormone