Like-triple diabetes as first manifestation of MODY2 in an overweight teenager with transient multiple antibodies.

An 11-year-old, prepubertal, Caucasian overweight boy (BMI 22.5 kg/m) with gynecomastia/steatomastia and diabetes was diagnosed on the basis of an oral glucose tolerance test without any typical symptoms (2-h blood glucose 215 mg/dL). Insulin levels were quite high (fasting 17.1 IU/mL, 2-h 114 IU/mL). Since 6 years of age he had been treated for Asperger syndrome, currently with risperidone. His family history was positive for diabetes in the previous three generations. At the time of diabetes diagnosis, dyslipidemia with elevated total cholesterol (212 mg/dL), triglycerides (150 mg/dL), and LDL cholesterol (133.1 mg/dL) was observed. Diabetes autoantibodies were significantly positive: islet antigen 2 antibodies (IA-2A) 46 units/mL (N ,20), islet cell antibodies (ICA) 90 (N ,0), glutamic acid decarboxylase antibodies (anti-GAD) 158.2 units/mL (N ,9.1), and insulin autoantibodies (IAA) 11.3% (N ,7). Heterozygosis for GCG/GAG mutation in the glucokinase gene was detected (data were from the patient’s medical documentation from another medical center).