A 25 year old man presented with diabetes for the past 1 year that is well controlled on oral hypoglycaemic agents. He also has a family history of diabetes in young. The diagnosis is:-
**Core Concept**
The patient's presentation of diabetes in a young individual with a family history of diabetes in young suggests a possible genetic predisposition to the disease. This could indicate a form of diabetes that is associated with specific genetic mutations.
**Why the Correct Answer is Right**
The patient's symptoms and family history are suggestive of maturity-onset diabetes of the young (MODY). MODY is a form of diabetes that is caused by genetic mutations in the HNF1A gene, which codes for a transcription factor involved in pancreatic beta-cell function. These mutations lead to impaired insulin secretion, resulting in hyperglycemia. The fact that the patient's diabetes is well-controlled on oral hypoglycemic agents suggests a mild form of the disease.
**Why Each Wrong Option is Incorrect**
**Option A:** Type 1 diabetes mellitus typically presents in childhood or adolescence and is characterized by an autoimmune destruction of pancreatic beta cells. This patient's age and family history do not support this diagnosis.
**Option B:** Type 2 diabetes mellitus is more common in older adults and is associated with insulin resistance and impaired insulin secretion. While this patient is young, his family history and well-controlled diabetes on oral hypoglycemic agents suggest a different diagnosis.
**Option C:** Gestational diabetes mellitus occurs during pregnancy and is typically transient. This patient's presentation is not related to pregnancy.
**Clinical Pearl / High-Yield Fact**
MODY is a rare form of diabetes that accounts for approximately 1-2% of all diabetes cases. It is often associated with specific genetic mutations and can be inherited in an autosomal dominant pattern.
**Correct Answer:** C. Type 1 diabetes mellitus typically presents in childhood or adolescence and is characterized by an autoimmune destruction of pancreatic beta cells. This patient's age and family history do not support this diagnosis.