Endocrine Abstracts

The age group under 45 years is the most difficult to determine the type of diabetes mellitus (DM), it can include type 1 (DM1), type 2 (DM2), MODY and LADA diabetes. Objective of the study: to determine clinical markers for differential diagnosis of types of DM in young patients.

Materials and Methods: 202 patients with onset of diabetes aged 18 to 45 years were included: group 1 - 77 patients with MODY, 2 - 83 with DM 2, 3 - 14 with DM 1, 4 - 28 with LADA. The groups were comparable in terms of gender and age. Patients were compared according to aggravated heredity for DM, features of the onset of the disease, comorbid pathologies and baseline anthropometric parameters.

Results: Patients with MODY more often than with DM2, with DM1 and LADA had a burdened heredity for DM (95 and 79%, P=0.005, 95 and 29%, P<0.001, 95 and 64 P=0.035), more often relatives developed DM up to 45 years (70 and 29%, P<0.001, 70 and 14%, P<0.001) and more than in 3 generations (65 and 28%, P<0.001, 65 and 7%, P<0.001, 65 and 8%, P<0.001, 65 and 15%, P<0.001). Patients with DM2 had often than with MODY obesity (34 and 4%, P<0.001), diseases of the gastrointestinal tract (25 and 6%, P=0.001) and arterial hypertension (14 and 5%, P=0.044). Patients with DM1 had more often than in MODY and DM2 symptoms of DM (93 and 23%, P<0.001, 93 and 26%, P<0.001), weight loss (50 and 3%, P<0.001, 50 and 0%, P<0.001), ketoacidosis (64% and 1%, P<0.001, 64% and 1%, P<0.001). In DM1, ketoacidosis was more common than in LADA (64 and 15%, P=0.013). In LADA more often in DM2 were symptoms of DM (61 and 26%, P=0.016), weight loss (15 and 0%, P=0.017) and less often gastrointestinal tract diseases (0 and 25%, P=0.031). With LADA more often than with MODY were symptoms of DM (61% and 23%, P=0.009), obesity (31% and 4%, P=0.008) and thyroid pathology (31% and 9%, P=0.040).

Conclusion: Clinical characteristics for differential diagnosis of the type of DM are aggravated heredity for DM, weight of patients; the presence of clinical symptoms, ketoacidosis in the debut; the presence of arterial hypertension, concomitant diseases of the gastrointestinal tract and thyroid gland.

Acknowledgements: Abstract was written of the grant of the President of the Russia for state support of young Russian scientists - doctors of sciences MD-3017.2022.3.