Acknowledgement: This course is supported by educational grants from Celera and the Applera Charitable Foundation.

Diabetes is a heterogeneous disease. While the practitioner can generally distinguish between type 1 and type 2 diabetes on the basis of clinical features, there are rarer forms of the disease which do not follow this simple categorization. Among them are the monogenic forms of diabetes, which comprise 1-5% of all diabetes and include maturity onset diabetes of the young (MODY), maternally inherited diabetes and deafness (MIDD or “mitochondrial diabetes”), Wolfram syndrome (diabetes mellitus, diabetes insipidus, optic atrophy and deafness), and neonatal diabetes (permanent or transient).

Recent genetic discoveries have uncovered many of the causes for the Mendelian (single gene) forms of diabetes. These advances pose the question of whether monogenic diabetes syndromes should be reclassified according to a molecular etiology framework. The availability of targeted genetic testing and greater awareness of the prevalence of these conditions have raised the question of when and in whom such testing is indicated. This module focuses on the more common forms of MODY and neonatal diabetes, describing their genetic etiology, clinical presentation, diagnostic approaches and therapeutic strategies.

NUMBER OF CREDIT HOURS: The Harvard Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 1 hours to complete.

COST: $20.00 for the average learner. Participants living in emerging nations receive a 50% discount or can register for free. See our International Pricing Page for details.

OVERALL LEARNING OBJECTIVES:
As a result of participating in this session, learners should be able to:

1. Identify the clinical characteristics of the most common MODY subtypes
2. Decide in whom genetic testing is indicated
3. Make rational, genetically guided therapeutic choices

METHOD OF PARTICIPATION:

Registrants participate in the learning process by answering interactive multiple choice questions that are dispersed throughout the case presentation. You must answer a question correctly in order to continue through the course. If you answer a question incorrectly, you will be prompted to try again.

In order to earn credit, physicians must complete the entire educational activity before the termination date (see above). Non-physicians may register for the course but are not eligible for AMA PRA Category 1 Credits™. Instead, non-physicians will earn a certificate of participation after successfully completing the course before its termination date.

COMBINATION OF MEDIA USED:

This internet enduring material is a case-based, interactive presentation comprised mainly of text, interactive questions, and images. A variety of media, including video clips, audio clips, and Flash animation, may be presented. Links to any necessary plugins are provided when necessary, but no plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.

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JOSE C. FLOREZ, MD, PhD Course Director

Jose C. Florez, M.D., Ph.D. is an Assistant in Medicine (Endocrine Division) at the Massachusetts General Hospital, an Associate Professor at Harvard Medical School, and an Associate Member at the Broad Institute, where he is active in the Program in Medical and Population Genetics and the Broad Metabolism Initiative. He and his group have contributed to the performance and analysis of genome-wide association studies in type 2 diabetes and related traits, in the Diabetes Genetics Initiative (formed by the Broad Institute, Lund University and Novartis), the Framingham Heart Study, and other international consortia such as MAGIC, GENIE and DIAGRAM. He leads the genetic research efforts of the Diabetes Prevention Program, where the effects of genetic variants on the development of diabetes can be examined prospectively, and their impact on specific behavioral and pharmacological preventive interventions can be assessed. He is the Principal Investigator of the Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans (SUGAR MGH), and also conducts other pharmacogenetic studies at MGH. He is an author on 70+ original publications and 30+ reviews/book chapters. In addition to his research and teaching duties, he directs the MGH Down Syndrome Clinic for Adults and Adolescents, and is clinically active in the MGH Diabetes Center and in the Endocrine inpatient consult service. He serves on the Editorial Boards for Diabetes and for Human Genetics, as well as the Advisory Board for Diabetologia; he is also the Editor-in-Chief for Current Diabetes Reports. He is the recipient of the MGH Physician Scientist Development Award, a Doris Duke Charitable Foundation Clinical Scientist Development Award, the MGH Department of Medicine Stephen Krane Award, and the 2010 Presidential Early Career Award for Scientists and Engineers, the highest honor bestowed by the United States government on science and engineering professionals in the early stages of their independent research careers. DISCLOSURE: Eli Lilly and Company, Consultant Pfizer, Consultant Novartis, Consultant

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SIRI ATMA GREELEY, MD, PHD Reviewer

Siri Atma Greeley, MD PhD is an Instructor of Pediatrics in the Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism and the Kovler Diabetes Center at the University of Chicago. He has been studying diabetes since the age of 14 years, when his father was diagnosed with type 1 diabetes. Dr. Greeley completed his undergraduate education at Columbia University in New York before earning his medical degree and PhD in the immunology of type 1 diabetes from the University of Pennsylvania School of Medicine. Dr. Greeley hopes to shed light on the spectrum of diabetes in childhood and has an active clinical practice in which he sees patients with all forms of diabetes. His current research focuses on monogenic diabetes (diabetes caused by a single gene mutation), which can be difficult to distinguish from the more common types. In particular, neonatal diabetes that occurs in the first few months of life commonly has an underlying monogenic cause and can often be treated with pills instead of insulin (http://NeonatalDiabetes.org). Dr. Greeley is helping to establish the University of Chicago as a national center for the study of monogenic diabetes. By uncovering the mechanisms of beta cell failure in patients with a genetically definable defect, Dr. Greeley and his colleagues hope to shed light on all forms of diabetes. DISCLOSURE: Reported no relevant financial relationships with commercial entities

CHRISTINA M. JACOBSEN, MD Reviewer

Dr. Jacobsen is a Clinical Fellow in Pediatrics at Children's Hospital Boston. DISCLOSURE: Reported no relevant financial relationships with commercial entities

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SANJIV CHOPRA, MD Planner

Dr. Sanjiv Chopra is Professor of Medicine and Faculty Dean for Continuing Medical Education at Harvard Medical School and Senior Consultant in Hepatology at the Beth Israel Deaconess Medical Center, Boston. In his role as Faculty Dean for Continuing Education, Dr. Chopra provides oversight and leadership of the Department and oversees the academic development of our programs. Dr. Chopra is an experienced clinician, researcher, and educator. In his research roles, he has served both as a principal investigator as well as co-investigator. He has more than 120 publications and five books to his credit, addressing topics in disease states, patient care, and leadership. Dr. Chopra’s teaching experience is extensive, and he has won numerous teaching awards for his work with medical students, residents and physicians. Currently, he directs and speaks at 10 multiday CME courses, nine of which are through HMS. For his full bio, please click here. DISCLOSURE: Reported no relevant financial relationships with commercial entities

ERIN HARVEY, MSC, CGC Planner

Erin K. Harvey, MSc, CGC, was the Assistant Director of Education for Partners Healthcare Center for Personalized Genetic Medicine (PCPGM) from 2008 to 2011. She is a board-certified genetic counselor and has worked with a wide range of primary healthcare professionals in the development of genetics-related, case-based continuing medical education (CME). In addition to being the series editor for PCPGM’s genetics CMEs, she coordinated an advanced human genetics course for Harvard Medical School’s Clinical Genetics Residency training program. In 2011, she accepted a position with Genzyme as a Scientific Communications Principal for the Personalized Genetic Health division. Prior to joining PCPGM, Ms. Harvey spent five years with the National Coalition for Health Professional Education in Genetics, and was seconded for one year to the United Kingdom to help a similar organization there – the National Genetics Education and Development Centre – create genetics resources for the UK’s nationalized medical education curriculum. Ms. Harvey received her master’s degree in science in 2003 from the Johns Hopkins University/National Institutes of Health joint genetic counseling training program. She received a B.A. in English Writing from St. Edward’s University in Austin, Texas in 1993, and worked as a journalist prior to pursuing a career in the biological sciences. DISCLOSURE: Reported no relevant financial relationships with commercial entities

ANDI LONG, EDM Planner

Andi Long directs the Department of Continuing Education’s Distance Learning group, which offers a variety of online continuing medical education programs to health care professionals around the world. Andi develops strategies for new pilot programs and systematically rolls out new distance learning initiatives and has a leadership role in IT planning and other online processes for HMS DCE. She oversees the day-to-day operations of each distance learning activity and ensures ACCME compliance across all enduring programs. She has had the privilege of working with hundreds of Harvard Medical School Faculty members to develop high-quality, engaging online programs that physicians in more than 170 countries have taken part in. Andi earned her Ed.M. in Technology, Innovation, and Education from Harvard Graduate School of Education and graduated from Bridgewater State College, summa cum laude, with a degree in English. Her professional interests focus on teaching and learning with new technologies and online course development. DISCLOSURE: Reported no relevant financial relationships with commercial entities

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NUMBER OF CREDITS: 1 

The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Harvard Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 1 hours to complete.

Within 2 weeks of completing the course, you will receive your certificate via email.

Click the image to view a sample of the certificate

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