Evidence map›Paper›PMID 28701371›Full record

ArticleDiabetes care2017

Population-Based Assessment of a Biomarker-Based Screening Pathway to Aid Diagnosis of Monogenic Diabetes in Young-Onset Patients.

Beverley M Shields, Maggie Shepherd, Michelle Hudson, Timothy J McDonald, Kevin Colclough, Jaime Peters, Bridget Knight, Chris Hyde, Sian Ellard, Ewan R Pearson and 2 more

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in Diabetes care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05918484 (Usefulness of Intermittently Scanned Continuous Glucose Monitoring in the Diagnosis of Maturity-onset Diabetes of the Young), which is not on this map. Cited by 75 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 2 pooled it
15.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05918484 completednot on this mapstarted 2023, after this paper: background citation

Usefulness of Intermittently Scanned Continuous Glucose Monitoring in the Diagnosis of Maturity-onset Diabetes of the Young (MODY) Patients

TypeobservationalSponsorCastilla-La Mancha Health ServiceRan2023 to 2025Enrolled500ConditionsType 1 Diabetes, MODYArmsIntermittenly scanned continuous glucose monitoring, MODY genetic diagnostic test
3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 2 syntheses or guidelines pooled it, 149 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Population Prevalence, Penetrance, and Mortality for Genetically Confirmed MODY.The Journal of clinical endocrinology and metabolism · 2026
    Article
  9. Review
  10. The evolution of C-peptide's role in diabetes care.Current opinion in endocrinology, diabetes, and obesity · 2026
    Review
  11. Article
  12. RareBiomedicines · 2025
    Article
  13. Article
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review

15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Beverley M ShieldsInstitute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K.ORCID 0000-0003-3785-327X
Maggie ShepherdInstitute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K.
Michelle HudsonInstitute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K.
Timothy J McDonaldInstitute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K.ORCID 0000-0003-3559-6660
Kevin ColcloughMolecular Genetics Diagnostic Laboratory, Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K.
Jaime PetersExeter Test Group, University of Exeter Medical School, Exeter, U.K.
Bridget KnightInstitute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K.
Chris HydeExeter Test Group, University of Exeter Medical School, Exeter, U.K.
Sian EllardInstitute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K.
Ewan R PearsonDivision of Molecular & Clinical Medicine, School of Medicine, University of Dundee, Dundee, U.K.
Andrew T HattersleyInstitute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, U.K. a.t.hattersley@exeter.ac.uk.ORCID 0000-0001-5620-473X
UNITED study team
University of Exeter · GBRoyal Devon & Exeter NHS Foundation Trust · GBUniversity of Dundee · GB

Funding

Department of Health NF-SI-0611-10219Department of Health NIHR-HCS-P12-03-03Department of Health RDECRF-2012-1Wellcome Trust 098395Wellcome Trust 102820/Z/13/Z
6 · The paper itself

Abstract

objectiveMonogenic diabetes, a young-onset form of diabetes, is often misdiagnosed as type 1 diabetes, resulting in unnecessary treatment with insulin. A screening approach for monogenic diabetes is needed to accurately select suitable patients for expensive diagnostic genetic testing. We used C-peptide and islet autoantibodies, highly sensitive and specific biomarkers for discriminating type 1 from non-type 1 diabetes, in a biomarker screening pathway for monogenic diabetes. RESEARCH DESIGN AND

methodsWe studied patients diagnosed at age 30 years or younger, currently younger than 50 years, in two U.K. regions with existing high detection of monogenic diabetes. The biomarker screening pathway comprised three stages:

resultsA total of 1,407 patients participated (1,365 with no known genetic cause, 34 with monogenic diabetes, and 8 with cystic fibrosis-related diabetes). A total of 386 out of 1,365 (28%) patients had a UCPCR ≥0.2 nmol/mmol, and 216 out of 386 (56%) were negative for GAD and IA2 and underwent molecular genetic testing. Seventeen new cases of monogenic diabetes were diagnosed (8 common Maturity Onset Diabetes of the Young [Sanger sequencing] and 9 rarer causes [next-generation sequencing]) in addition to the 34 known cases (estimated prevalence of 3.6% [51/1,407] [95% CI 2.7-4.7%]). The positive predictive value was 20%, suggesting a 1-in-5 detection rate for the pathway. The negative predictive value was 99.9%.

conclusionsThe biomarker screening pathway for monogenic diabetes is an effective, cheap, and easily implemented approach to systematically screening all young-onset patients. The minimum prevalence of monogenic diabetes is 3.6% of patients diagnosed at age 30 years or younger.

Indexed as

AdultAutoantibodiesBiomarkersCohort StudiesC-PeptideCreatinineDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2FemaleHepatocyte Nuclear Factor 1-alphaHepatocyte Nuclear Factor 4High-Throughput Nucleotide SequencingHumansInsulinMaleMiddle AgedAutoantibodiesBiomarkersC-PeptideCreatinineHepatocyte Nuclear Factor 1-alphaHepatocyte Nuclear Factor 4HNF1A protein, humanHNF4A protein, humanICA512 autoantibodyInsulin

Identifiers

PMID28701371
PMCPMC5570522
OpenAlexW2612062408

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.