实用医学杂志 ›› 2023, Vol. 39 ›› Issue (2): 137-141.doi: 10.3969/j.issn.1006⁃5725.2023.02.002

• 专题报道 • 上一篇    下一篇

单基因糖尿病的早期识别与精准治疗

刘丽 李秀珍   

  1. 广州市妇女儿童医疗中心遗传与内分泌科(广州 510063)
  • 出版日期:2023-01-25 发布日期:2023-01-25
  • 基金资助:
    广东省科技发展专项资金(编号:2017A020215111)

Early identification and precise treatment of monogenic diabetes

LIU Li,LI Xiuzhen
  

  1. Department of Genetics and Endocrinology,Guangzhou Women and Children′s Medical Center,Guangzhou 510063,China

  • Online:2023-01-25 Published:2023-01-25

摘要:

单基因糖尿病(monogenic diabetes,MD)涵盖了广泛的异质性疾病,包括新生儿糖尿病、青少年发病的成人型糖尿病和综合征型糖尿病,明确基因诊断有助于实现精准治疗。随着临床医生逐渐重视对分类不明确的糖尿病进行分子遗传学的筛查,MD 确诊患者日渐增多。但目前 MD 治疗往往是超说明书用药,相关指南或共识对具体用药时机和剂量阐述甚少,如何实施精准治疗成为临床面临的新挑战。本文梳理MD的临床与分子遗传学特征,重点阐述对几种有特效治疗方法的MD如何实施个体化治疗及遗传咨询。

关键词: 单基因糖尿病, 基因, 诊断, 精准治疗

Abstract:

Monogenic diabetes(MD)covers a wide range of heterogeneous diseases,including neonatal diabetes,maturity onset diabetes of the young and syndromic diabetes. The genetic diagnosis of MD helps to achieve precise therapy. As clinicians pay more attention to genetic screening in diabetes,more MD patients are identified. However,currently,the medicines of MD are often off ⁃label used,and the relevant guidelines or consensus rarely describe the detailed timing and dosage of medication. Thus,the main clinical challenge is how to implement precise treatment for MD cases. This study aims tosummarize the clinical and genetic characteristics of MD and describe how to implement individualized treatment and genetic counseling for several kinds of MD with specific treatment methods.

Key words:

monogenic diabetes, gene, diagnosis, precision treatment