Non-ketotic diabetes in Saudi Arabian youths: MODY or early onset of type 2 diabetes?

Background: Non-ketotic diabetes mellitus is commonly seen in young Saudi Arabian adults. This could be either early onset of typical type 2 diabetes, T2DM or maturity-onset diabetes of the young, MODY. Consanguinity is also prevalent and clouds the inheritance pattern of the disease. Distinction between the two on clinical grounds alone is not always possible. Materials and Method: Diabetic patients aged ≤ 25 years with family history of the disease who had maintained reasonable glycaemic control with diet and/or oral hypoglycaemic agents for at least two years were studied. Demographic data, presentation details and clinical course were analyzed for classification of patients as possible cases of MODY, using generally accepted criteria. Results: Twenty three patients with diabetes through three consecutive generations were identified as possible cases of MODY from a clinic population of about 200. However, they could also have been early onset cases of T2DM, and differentiation between the two could not be made with certainty without further tests. Conclusion: More studies including genetic testing would be needed to differentiate between early onset T2DM and MODY, according to the current WHO classification. Since most developing countries among which the increasing burden of DM lies cannot do this, there is a need to review the current classification of diabetes. (Int J Diabetes Metab 15:60-61, 2007)