What are the most recent screening and diagnostic criteria for maturity-onset diabetes of the young (MODY)?—NANCY GOBEN, RN, MSN, ANP-C, Oneonta, N.Y.
MODY occurs in only 1%-2% of diabetes cases. It is a genetic defect that is autosomal-dominant in its inheritance. Children of a parent with MODY have a 50% chance of inheriting the defective gene. This condition (1) usually develops in people younger than age 25 years; (2) runs in families; (3) is often found in families in which one parent and one grandparent has diabetes; (4) usually does not require insulin therapy; and (5) does not typically involve overweight patients.
When determining treatment, it is important to remember that this is a problem of decreased insulin production, not decreased insulin sensitivity or response. MODY patients will continue to respond well to insulin secretagogues and may not respond well to other first-line agents currently recommend for type 2 diabetes (e.g., metformin). Genetic testing is important for family planning.—Julee B. Waldrop, DNP (146-10)