Clinical Characteristics Of Patients With Early-onset Diabetes In Yangzhou Area

Introduction: In this study,the inpatient records of patients with early-onset diabetes in Yangzhou area of China were collected,and gene sequencing was used to distinguish between type 2 diabetes mellitus(T2DM)and mitochondrial diabetes mellitus(MIDD),and the clinical characteristics of each subgroup were analyzed statistically.This paper aims to use systematic screening strategies to select suitable candidates for genetic testing to achieve early diagnosis of MIDD,improve the detection rate,further clarify the difference between MIDD and T2 DM,explore the causes and potential mechanisms of its formation,and provide new ideas and basis for clinical diagnosis and treatment,which is helpful for accurate classification and treatment of patients with early-onset diabetes.Methods: From 2020 to 2022,118 inpatients from the Department of Endocrinology of the Affiliated Hospital of Yangzhou University met the screening criteria and the diagnostic and typing criteria for diabetes(World Health Organization(WHO)1999edition),their medical records were collected and peripheral venous blood was collected,and all the patients included met the diabetes classification and diagnostic criteria(World Health Organization(WHO)1999 edition).These patients were then genetically tested to check whether they carried mitochondrial DNA 3243 locus A>G(m.3243A>G)mutations,and all diabetic patients were divided into two subgroups of MIDD and T2 DM according to the sequencing results,and the clinical characteristics of each group were statistically analyzed.Results:1.Among the 118 patients enrolled with early onset diabetes,m.3243 A > G mutation in the mitochondrial DNA-encoded t RNA was detected in 8 people(6.8%)through genetic testing.2.The SPSS software was used to statistically analyze the general clinical data and laboratory examination indexes of patients,and the results showed that there were differences in body mass index(BMI),C-peptide concentrations(C-P),0.5-h postprandial C-peptide(0.5h C-P),2-h postprandial C-peptide(2h C-P),3-h postprandial C-peptide(3h C-P),triglycerides(TG),and thyroid stimulating hormone(TSH)levels in patients with MIDD and T2 DM,and the differences were statistically significant(P<0.05).3.More than 50% of MIDD patients had diabetic peripheral neuropathy,37.5% had thyroid dysfunction,and non-alcoholic fatty liver disease was relatively uncommon,and treatment was mostly insulin dependent.4.We also found one patient with gestational diabetes mellitus(GDM),all four of her sisters had a history of diabetes,the patient stopped hypoglycemic drugs after delivery,and 12 years later(39 years old)relapsed,only blurred vision as the main manifestation,no diabetes complications were found,and insulin hypoglycemic therapy was given after discharge.5.Interestingly,MIDD patients with mitochondrial DNA 3243 A>G mutation G/(A+G)peak ratio was negatively correlated with age,disease duration,2h PG and FT4(p<0.05).Conclusion:1.There were statistical differences in BMI,C-P,0.5h C-P,2h C-P,3h C-P,TG,and TSH in patients with MIDD and T2 DM.2.Patients with MIDD have widespread diabetic peripheral neuropathy,some have thyroid dysfunction,non-alcoholic fatty liver disease is uncommon,most patients with MIDD rely on insulin therapy.3.There was a negative correlation(p<0.05)between mitochondrial DNA 3243A>G mutation G/(A+G)peak ratio and age,disease course,2h PG and FT4 in patients with MIDD,indicating that gene sequencing can not only be used for the diagnosis of patients,but also may be closely related to the occurrence and development of the disease,and can be used to assess the severity of the disease in patients.