GCK-MODY with Mild Stable Non-Progressive Fasting Hyperglycemia in an Asymptomatic Child or Adolescent
GCK-MODY is the commonest subtype of monogenic diabetes in the pediatric diabetes clinic. Its clinical phenotype is remarkably homogeneous: mild, stable, non-progressive fasting blood glucose of 5.5–8 mmol/L (100–145 mg/dL) with HbA1c typically below 7.5% (59 mmol/mol), in an otherwise asymptomatic child or adolescent.
Clinical scenario: An asymptomatic child or adolescent presents with incidentally detected mild fasting hyperglycemia. The stable, non-progressive pattern — fasting glucose 5.5–8 mmol/L and HbA1c below 7.5% — is the hallmark of this presentation.
Recognising this pattern matters: the incidental finding of mild hyperglycemia in otherwise asymptomatic young patients also raises the differential of subsequent type 1 or type 2 diabetes, making accurate characterisation of GCK-MODY clinically important.
References
GCK-MODY is the commonest subtype of monogenic diabetes in the pediatric diabetes clinic and its clinical phenotype is remarkably homogeneous among affected persons.
HbA1c is mildly elevated but usually below 7.5% (59 mmol/mol).
The incidental finding of mild hyperglycemia (5.5–8 mmol/L or 100–145 mg/dl) in otherwise asymptomatic children and adolescents raises the possibility that they will subsequently develop T1D or T2D.
DOI: 10.1111/pedi.13426
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