Update on Monogenic Diabetes in Korea

• Published in: Diabetes & metabolism journal Vol. 44; no. 5; pp. 627 - 639
• Main Authors: Yang, Ye Seul, Kwak, Soo Heon, Park, Kyong Soo
• Format: Journal Article
• Language: English
• Published: Sŏul Korean Diabetes Association / Daehan Dangnyobyeong Hakoe 01.10.2020; Korean Diabetes Association; 대한당뇨병학회
• Subjects: Body mass index; Diabetes; diabetes mellitus; Ethnicity; Genes; Genetic testing; mason-type diabetes; Mutation; Review; 내과학; United Kingdom > UK
• ISSN: 2233-6079; 2233-6087; 2233-6087
• DOI: 10.4093/dmj.2020.0214

Monogenic diabetes, including maturity-onset diabetes of the young, neonatal diabetes, and other rare forms of diabetes, results from a single gene mutation. It has been estimated to represent around 1% to 6% of all diabetes. With the advances in genome sequencing technology, it is possible to diagnose more monogenic diabetes cases than ever before. In Korea, 11 studies have identified several monogenic diabetes cases, using Sanger sequencing and whole exome sequencing since 2001. The recent largest study, using targeted exome panel sequencing, found a molecular diagnosis rate of 21.1% for monogenic diabetes in clinically suspected patients. Mutations in glucokinase (GCK), hepatocyte nuclear factor 1α (HNF1A), and HNF4A were most commonly found. Genetic diagnosis of monogenic diabetes is important as it determines the therapeutic approach required for patients and helps to identify affected family members. However, there are still many challenges, which include a lack of simple clinical criterion for selecting patients for genetic testing, difficulties in interpreting the genetic test results, and high costs for genetic testing. In this review, we will discuss the latest updates on monogenic diabetes in Korea, and suggest an algorithm to screen patients for genetic testing. The genetic tests and non-genetic markers for accurate diagnosis of monogenic diabetes will be also reviewed.