About this trial
Diabetes Mellitus is a disease that affects nearly 1 in 5 people in United Arab Emirates and is one of leading causes of death and disability. The main reason for this condition is either relative or near complete deficiency of essential hormone made by our pancreas called "insulin", which is required to utilize blood sugar (glucose), and insulin shortage leads to increased blood glucose. The common types of this condition include type 2 Diabetes Mellitus (the most common with almost 90% of all diabetes patients having this condition), which is related to mismatch of body requirements and production of essential hormone called insulin (relative deficiency) and type 1 diabetes, in which body's own defense system causes of destruction of insulin producing cells in the pancreas (near complete deficiency of insulin). However, in younger age group (below the age of 35) there is another type of diabetes which affects nearly 1 out 1000 people and is Maturity onset diabetes of the young (MODY). MODY is a condition passed by parents in 50% of the kids due to an affected single gene and most common forms of MODY do not require any Insulin treatment. However as type 1 Diabetes is generally identified in younger age group, 80% of patient who have MODY cannot be diagnosed and are labelled with other forms of diabetes instead, and may receive unnecessary insulin injections. Although, there has been a lot of research done in the west on prevalence of MODY in white/Caucasian population, the studies in Middle East are minimal. Also, in the white/Caucasian population, a reliable risk calculator has been developed that predicts the risk of having MODY, which if found to be high, is then confirmed by genetic testing for MODY. There is no study available on presence of MODY or on the reliability of the MODY risk calculator among young Emirati population. There is also no data on MODY being misdiagnosed as other forms of diabetes in Emirati population.
This study proposal aims to address this gap of knowledge and assess the reliability of MODY calculator in young Emirati patients with diabetes and to see if any MODY patient exist in Diabetes clinics of Tawam hospital Abu Dhabi, who may have been misdiagnosed as type 1 or type 2.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age > 11; both male or female, Emirati patients only
Diagnosed to have Type 1 or Type 2 Diabetes Mellitus diagnosed before the age of 40 and after the age of 6 months.
Attended Tawam hospital during the last 1 year.
All previous antibodies testing being negative.
Disqualifiers
BMI of 40 or above (class 3 / severe obesity)
History of Secondary diabetes (e.g. Diabetes following pancreatitis)
Absent/Decreased C-peptide activity suggestive of Type 1 Diabetes
Trial design
Single group
Treatments tested in this trial
Genetic testing for 4 MODY genes (GCK, HNF1A, HNF4A, HNF1B)
Diagnostic testGenetic testing for 4 MODY genes (GCK, HNF1A, HNF4A, HNF1B) to look for common non-syndromic MODY in Emirati population
Treatment groups
Trial outcomes
Primary outcomes
To see how many patient with diabetes diagnosed at early age with features not suggestive of type 1 or type 2 are found to have MODY monogenic diabetes (commonest subtypes) among young Emirati patients
To assess the frequency of MODY monogenic diabetes (commonest subtypes) among patients already labelled as Type 1 or Type 2 Diabetes (who have negative autoimmunity, lack of significant ketosis and either family history of diabetes in one parent or BMI\<40).
Secondary outcomes
To compare the value of MODY risk calculator and genetic testing outcome in Emirati patients
To assess the validity of MODY risk calculator for prediction of monogenic diabetes in Emirati patients
To see if C-peptide activity helps in differentiating monogenic diabetes from type 1
To assess the validity of C-peptide activity level in differentiating type 1 diabetes from type 2 diabetes and monogenic diabetes
To find out the antibodies present in young patient with diabetes and if they are helpful in ruling out monogenic diabetes
To assess the validity of Insulin antibodies (anti-GAD65, IAA2, Anti-Zn8) in ruling out monogenic diabetes
Locations
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