Is the MODY (Maturity-Onset Diabetes of the Young) calculator valid for pediatric patients?

From the Guidelines

The MODY calculator is valid for pediatric patients, as it helps identify children and adolescents who may have monogenic diabetes rather than type 1 or type 2 diabetes, and its use can lead to more precise diagnosis and personalized treatment approaches. The calculator incorporates factors like age at diagnosis, family history of diabetes, body mass index, and presence of autoantibodies to determine the probability of MODY 1. Early identification of MODY in pediatric patients is crucial because it can significantly impact treatment decisions, such as the use of sulfonylureas instead of insulin for certain MODY subtypes like HNF1A or HNF4A mutations. The American Diabetes Association recommends considering the possibility of MODY, particularly in antibody-negative youth with diabetes, and emphasizes the importance of genetic testing for MODY in pediatric patients with a suggestive clinical presentation 1.

Some key points to consider when using the MODY calculator in pediatric populations include:

• The calculator's ability to identify patients who may benefit from genetic testing for MODY
• The importance of considering MODY in the differential diagnosis of pediatric diabetes, particularly in patients with a family history of diabetes or those who do not respond typically to insulin therapy
• The potential for personalized treatment approaches based on the results of genetic testing and the specific MODY subtype diagnosed
• The need for ongoing monitoring and management of pediatric patients with MODY to optimize their outcomes and quality of life.

Overall, the use of the MODY calculator in pediatric populations can help clinicians provide more accurate diagnoses and effective treatment plans for children and adolescents with monogenic diabetes.

From the Research

Mody Calculator Validity for Pediatric Patients

• The Mody calculator is a tool used to aid in the identification of Maturity Onset Diabetes of the Young (MODY) in patients at the time of diabetes diagnosis 2.
• A study published in 2024 developed a MODY probability calculator for pediatric cases, which showed excellent discrimination and calibration in identifying MODY cases 2.
• The calculator uses factors such as HbA1c, parent with diabetes, and absence of polyuria to predict the probability of MODY 2.
• Another study published in 2024 discussed the importance of accurate diagnosis of MODY, which can be achieved through the use of a MODY calculator or other diagnostic tools 3.
• The calculator can help target genetic testing to those most likely to benefit, allowing for the right diagnosis and treatment 2, 4.

Clinical Features and Diagnostic Approach

• MODY is a monogenic disorder that typically presents at <25 years of age, is non-insulin dependent, and is familial, with an autosomal dominant pattern of inheritance 5.
• The most common forms of MODY are caused by mutations in glucokinase and hepatic nuclear factor 1 alpha or 4 alpha genes 5.
• A thorough history, physical examination, multigenerational family history, and lab evaluation are necessary for the diagnosis of MODY 6.
• The presence of clinical features with 3 (or more) negative antibodies may be indicative of MODY-monogenic diabetes, and is followed by genetic testing 6.

Treatment and Monitoring

• Treatment of MODY depends on the specific variant identified, and may include oral sulfonylureas or other medications 3, 6.
• Monitoring for microvascular and macrovascular complications is also important in the management of MODY 6.
• Recent therapeutic advancements have been made for patients who no longer respond to first-line therapy, and these may be considered in the treatment of MODY 6.