Comparison of Clinical Features and Mortality Rate of Adult Patients with Multigenerational Diabetes and of Patients with Type 2 Diabetes Mellitus

Clinical experience teaches us that some adult patients who are diagnosed as having type 2 diabetes (T2D) are, instead, components of families with a multigenerational form of diabetes. We investigated clinical features and mortality rate of such patients as compared to those with T2D. From 2,583 consecutive Italian patients who had been routinely defined as affected by T2D, we looked for those belonging to families with diabetes in 3 or more consecutive generations. After excluding patients carrying known MODY gene mutations (n=22), clinical features of those affected by what we propose to define as “familial diabetes of the adulthood” (FDA; n=134) were compared to those of 1,208 T2D patients, not belonging to multigenerational (>2) pedigrees, who have been previously characterized for studying risk factors of all-cause mortality. In an age-adjusted model, age at diagnosis (p<0.001), waist circumference (p=0.03) and proportion of hypertension (p=0.001) were lower in FDA than in T2D. The two groups were similar for BMI, HbA1c, anti-hyperglycemic treatment, albuminuria and the proportion of dyslipidemia. In 121 FDA and 837 T2D patients, age-adjusted incidence rate of all-cause mortality was similar: 1.92 vs. 1.90 event per 100 person-years. In conclusion, this is the first report on clinical characteristics of adult patients from families with a multigenerational form of diabetes, we propose to define as FDA. FDA patients are characterized by a younger age at diagnosis, a lower waist circumference and a reduced proportion of hypertension, as compared to T2D patients. Though all-cause mortality rate is superimposable, it remains to be investigated whether such differences shape a different cardiovascular risk in these two groups of patients.