Rare and common genetic variants may interact with environmental factors to cause young-onset diabetes
While the prevalence of young-onset diabetes is rising worldwide, it is increasing particularly rapidly in Asian and Indigenous Australian populations. In Asia, one in five people with diabetes is diagnosed before the age of 40;1 in Australia, Indigenous Australians are six times as likely to develop diabetes during adolescence or childhood as Australians of European background.2 People with young-onset diabetes comprise a heterogeneous group, with aetiologies including classic type 1 diabetes, latent autoimmune diabetes in adults (LADA), type 2 diabetes, and the rarer monogenic maturity-onset diabetes of the young (MODY).3 Differentiating these subtypes is challenging, particularly in 20–40-year-old patients, among whom the proportions of the subtypes may vary by ethnic group.
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- 1. Yeung RO, Zhang Y, Luk A, et al. Metabolic profiles and treatment gaps in young-onset type 2 diabetes in Asia (the JADE programme): a cross-sectional study of a prospective cohort. Lancet Diabetes Endocrinol 2014; 2: 935-943.
- 2. Craig ME, Femia G, Broyda V, et al. Type 2 diabetes in Indigenous and non-Indigenous children and adolescents in New South Wales. Med J Aust 2007; 186: 497-499. <MJA full text>
- 3. Kong APS, Chow EY, Chan JC. Other disorders with type 1 phenotype. In: Holt RIG, Cockram CS, Flyvbjerg A, Goldstein BJ, editors. Textbook of diabetes. 5th edition. Chichester: John Wiley & Sons, 2017; pp. 154-160.
- 4. Davis TME, Makepeace AE, Ellard S, et al. The prevalence of monogenic diabetes in Australia: the Fremantle Diabetes Study Phase II. Med J Aust 2017; 207: 344-347.
- 5. Shields BM, McDonald TJ, Ellard S, et al. The development and validation of a clinical prediction model to determine the probability of MODY in patients with young-onset diabetes. Diabetologia 2012; 55: 1265-1272.
- 6. Ang SF, Lim SC, Tan C, et al. A preliminary study to evaluate the strategy of combining clinical criteria and next generation sequencing (NGS) for the identification of monogenic diabetes among multi-ethnic Asians. Diabetes Res Clin Pract 2016; 119: 13-22.
- 7. Ng MC, Cockburn BN, Lindner TH, et al. Molecular genetics of diabetes mellitus in Chinese subjects: identification of mutations in glucokinase and hepatocyte nuclear factor-1alpha genes in patients with early-onset type 2 diabetes mellitus/MODY. Diabet Med 1999; 16: 956-963.
- 8. O’Dea K, Patel M, Kubisch D, et al. Obesity, diabetes, and hyperlipidemia in a central Australian Aboriginal community with a long history of acculturation. Diabetes Care 1993; 16: 1004-1010.
- 9. Braun B, Zimmermann MB, Kretchmer N, et al. Risk factors for diabetes and cardiovascular disease in young Australian Aborigines. A 5-year follow-up study. Diabetes Care 1996; 19: 472-479.
- 10. Chan J, Chow E, Luk A. Diabetes in China and the Western Pacific Region. In: Dagogo J, editor. Diabetes mellitus in developing countries and underserved communities. Cham (Switzerland): Springer; 2017; pp. 63-83.
- 11. Chamberlain C, Banks E, Joshy G, et al. Prevalence of gestational diabetes mellitus among Indigenous women and comparison with non-Indigenous Australian women: 1990-2009. Aust N Z J Obstet Gynaecol 2014; 54: 433-440.
- 12. Tutino GE, Tam WH, Yang X, et al. Diabetes and pregnancy: perspectives from Asia. Diabet Med 2014; 31: 302-318.
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