Glucokinase variant-induced maturity-onset diabetes of the young (GCK-MODY) exhibits the unique clinical features of mild fasting hyperglycaemia. However, formal studies of its glucose excursion pattern in daily life in comparison with those with or without other types of diabetes are lacking. We conducted a case-control study including 25 patients with GCK-MODY, 25 A1c-matched, drug naive patients with type 2 diabetes (T2DM) and 25 age-, BMI- and sex-matched subjects with normal glucose tolerance (NGT). All the subjects wore flash glucose monitoring (FGM) sensors for 2 weeks, and glucose readings were masked. Glucose excursion was significantly lower in the GCK-MODY than that in A1c-matched T2DM during the daytime, but was similar during the nighttime. The daytime coefficient of variation [CV] driven by postprandial glucose could separate GCK-MODY from well-controlled T2DM, but the nighttime CV could not. In discriminating between GCK-MODY and T2DM, the area under the curve (AUC) of the CV was 0.875. However, in GCK-MODY and NGT subjects, the CVs were similar at 24h, whereas the other four excursion parameters were significantly higher in GCK-MODY than those in NGT subjects. FGM confirmed the stability and mildness of hyperglycemia in GCK-MODY patients. Postprandial regulation is a key driver of the difference in excursion between GCK-MODY and T2DM.

中文翻译：

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连续血糖监测技术对GCK-MODY与2型糖尿病每日血糖波动的比较

葡萄糖激酶变异体诱导的青少年成熟期发病糖尿病 (GCK-MODY) 表现出轻度空腹高血糖的独特临床特征。然而，与患有或不患有其他类型糖尿病的患者相比，缺乏对其日常生活中葡萄糖波动模式的正式研究。我们进行了一项病例对照研究，包括 25 名 GCK-MODY 患者、25 名 A1c 匹配、未用药的 2 型糖尿病 (T2DM) 患者和 25 名年龄、BMI 和性别匹配且葡萄糖耐量正常 (NGT) 的受试者。所有受试者都佩戴闪光葡萄糖监测 (FGM) 传感器 2 周，并且葡萄糖读数被屏蔽。在白天，GCK-MODY 的血糖波动明显低于 A1c 匹配的 T2DM，但在夜间相似。由餐后葡萄糖驱动的白天变异系数 [CV] 可以将 GCK-MODY 与控制良好的 T2DM 区分开来，但夜间 CV 不能。在区分 GCK-MODY 和 T2DM 时，CV 的曲线下面积 (AUC) 为 0.875。然而，在 GCK-MODY 和 NGT 受试者中，CV 在 24 小时时相似，而其他四个偏移参数在 GCK-MODY 中明显高于 NGT 受试者。FGM 证实了 GCK-MODY 患者高血糖的稳定性和温和性。餐后调节是 GCK-MODY 和 T2DM 之间偏移差异的关键驱动因素。而其他四个偏移参数在 GCK-MODY 中明显高于 NGT 受试者。FGM 证实了 GCK-MODY 患者高血糖的稳定性和温和性。餐后调节是 GCK-MODY 和 T2DM 之间偏移差异的关键驱动因素。而其他四个偏移参数在 GCK-MODY 中明显高于 NGT 受试者。FGM 证实了 GCK-MODY 患者高血糖的稳定性和温和性。餐后调节是 GCK-MODY 和 T2DM 之间偏移差异的关键驱动因素。