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Clinical features distinguishing type 1 diabetes, type 2 diabetes, and monogenic diabetes*

Clinical features distinguishing type 1 diabetes, type 2 diabetes, and monogenic diabetes*
Clinical features Type 1 diabetes mellitus Type 2 diabetes mellitus Monogenic diabetes
Age of diagnosis (years) Majority <25, but may occur at any age Typically >25 but incidence is increasing in adolescents, paralleling increasing rates of obesity in children and adolescents <25
Weight Usually thin, but with obesity epidemic overweight and obesity at diagnosis becoming more common >90% at least overweight Similar to general population
Autoantibodies Present Absent Absent
Insulin dependent Yes No No
Insulin sensitivity Normal when controlled Decreased Normal (may be decreased if obese)
Family history of diabetes Infrequent (5 to 10%) Frequent (75 to 90%) Multigenerational, ie, ≥3 generations
Risk of diabetic ketoacidosis High Low Low
* Formerly called maturity onset diabetes of the young (MODY).
¶ In North America, type 2 diabetes predominates in Hispanic American, African American, Native American, Canadian First Nation, Pacific Islander, and Asian American youth.
Data from:
  1. Naylor R, Philipson LH. Who should have genetic testing for maturity-onset diabetes of the young? Clin Endocrinol (Oxf) 2011; 75:422.
  2. Ramesh SC, Marshall I. Clinical Suspicion of Maturity Onset of Diabetes of the Young in Pediatric Patients Diagnosed with Diabetes Mellitus. Indian J Pediatr 2012; 79:955.
  3. Thanabalasingham G, Owen KR. Diagnosis and management of maturity onset diabetes of the young (MODY). BMJ 2011; 343:d6044.
  4. Pinhas-Hamiel O, Zeitler P. The global spread of type 2 diabetes mellitus in children and adolescents. J Pediatr 2005; 146:693.
  5. De Ferranti SD, Osganian SK. Epidemiology of paediatric metabolic syndrome and type 2 diabetes mellitus. Diab Vasc Dis Res 2007; 4:285.
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