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      GCK-MODY (MODY 2) Caused by a Novel p.Phe330Ser Mutation

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          Abstract

          Maturity onset diabetes of the young (MODY) is a monogenic form of diabetes inherited as an autosomal dominant trait. The second most common cause is GCK-MODY due to heterozygous mutations in the GCK gene which impair the glucokinase function through different mechanisms such as enzymatic activity, protein stability, and increased interaction with its receptor. The enzyme normally acts as a glucose sensor in the pancreatic beta cell and regulates insulin secretion. We report here a three-generation nonobese family diagnosed with diabetes. All affected family members presented with mild hyperglycemia and mostly slightly elevated hemoglobin A1c values. Genetic testing revealed a novel heterozygous T → C exchange in exon 8 of the GCK gene which resulted in a phenylalanine 330 TTC → serine (TCC)/p.Phe330Ser/F330S substitution.

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          Most cited references37

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          Molecular mechanisms and clinical pathophysiology of maturity-onset diabetes of the young.

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            Update on mutations in glucokinase (GCK), which cause maturity-onset diabetes of the young, permanent neonatal diabetes, and hyperinsulinemic hypoglycemia.

            Glucokinase is a key regulatory enzyme in the pancreatic beta-cell. It plays a crucial role in the regulation of insulin secretion and has been termed the glucose sensor in pancreatic beta-cells. Given its central role in the regulation of insulin release it is understandable that mutations in the gene encoding glucokinase (GCK) can cause both hyper- and hypoglycemia. Heterozygous inactivating mutations in GCK cause maturity-onset diabetes of the young (MODY) subtype glucokinase (GCK), characterized by mild fasting hyperglycemia, which is present at birth but often only detected later in life during screening for other purposes. Homozygous inactivating GCK mutations result in a more severe phenotype presenting at birth as permanent neonatal diabetes mellitus (PNDM). A growing number of heterozygous activating GCK mutations that cause hypoglycemia have also been reported. A total of 620 mutations in the GCK gene have been described in a total of 1,441 families. There are no common mutations, and the mutations are distributed throughout the gene. The majority of activating mutations cluster in a discrete region of the protein termed the allosteric activator site. The identification of a GCK mutation in patients with both hyper- and hypoglycemia has implications for the clinical course and clinical management of their disorder.
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              Familial hyperinsulinism caused by an activating glucokinase mutation.

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                Author and article information

                Journal
                ISRN Pediatr
                PEDIATRICS
                ISRN Pediatrics
                International Scholarly Research Network
                2090-469X
                2090-4703
                2011
                26 April 2011
                : 2011
                : 676549
                Affiliations
                1Division of Pediatric Endocrinology, Department of Pediatrics, Technische Universität München Kölner Platz 1, 80804 Munich, Germany
                2Institut für Diabetesforschung, Helmholtz Zentrum München, 85764 Neuherberg, Germany
                3Department of Clinical Chemistry, Klinikum Großhadern, Ludwig Maximilian University of Munich, 81377 Munich, Germany
                Author notes

                Academic Editor: G. Zuccotti

                Article
                10.5402/2011/676549
                3263572
                22389783
                b9aee25b-d2bd-444c-a276-5917aa410b3f
                Copyright © 2011 Walter Bonfig et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 January 2011
                : 13 March 2011
                Categories
                Case Report

                Pediatrics
                Pediatrics

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