The first validated childhood-onset diabetes register has been set up in the far south-west of England. The incidence of childhood Type 1 DM in this region has increased significantly over the past two decades, especially in children under 5 years.
Summary
We report a case of an 11-year-old girl presenting with a new diagnosis of diabetes associated with a heterozygous missense mutation in the insulin receptor (INSR) gene. This case highlights that INSR gene variants can be a cause for monogenic diabetes in children and adolescents and the need for genetic evaluation in atypical presentations of diabetes. We also describe the possible role of metformin in treating individuals with type A insulin resistance syndrome due to INSR gene variants.
Learning points
Insulin receptor (INSR) gene variants can be a cause of monogenic diabetes in children and adolescents.
Genetic evaluation should be considered in children and adolescents with type 2 diabetes (T2D), particularly where there is an atypical presentation and/or positive family history.
Metformin may have a role in the treatment of type A insulin resistance syndrome due to heterozygous mutation of the INSR gene.
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