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青少年成年起病型糖尿病(MODY)的基因诊断:患者及家庭成员的经历

A genetic diagnosis of maturity-onset diabetes of the young (MODY): experiences of patients and family members.

作者信息

Bosma A R, Rigter T, Weinreich S S, Cornel M C, Henneman L

机构信息

Department of Clinical Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

Diabet Med. 2015 Oct;32(10):1385-92. doi: 10.1111/dme.12742. Epub 2015 Mar 28.

Abstract

AIMS

Genetic testing for maturity-onset diabetes of the young (MODY) facilitates a correct diagnosis, enabling treatment optimization and allowing monitoring of asymptomatic family members. To date, the majority of people with MODY remain undiagnosed. To identify patients' needs and areas for improving care, this study explores the experiences of patients and family members who have been genetically tested for MODY.

METHODS

Fourteen semi-structured interviews with patients and the parents of patients, and symptomatic and asymptomatic family members were conducted. Atlas.ti was used for thematic analysis.

RESULTS

Most people with MODY were initially misdiagnosed with Type 1 or Type 2 diabetes; they had been seeking for the correct diagnosis for a long time. Reasons for having a genetic test included reassurance, removing the uncertainty of developing diabetes (in asymptomatic family members) and informing relatives. Reasons against testing were the fear of genetic discrimination and not having symptoms. Often a positive genetic test result did not come as a surprise. Both patients and family members were satisfied with the decision to get tested because it enabled them to adjust their lifestyle and treatment accordingly. All participants experienced a lack of knowledge of MODY among healthcare professionals, in their social environment and in patient organizations. Additionally, problems with the reimbursement of medical expenses were reported.

CONCLUSIONS

Patients and family members are generally positive about genetic testing for MODY. More education of healthcare professionals and attention on the part of diabetes organizations is needed to increase awareness and optimize care and support for people with MODY.

摘要

目的

对青年发病的成年型糖尿病(MODY)进行基因检测有助于正确诊断,实现治疗优化,并可对无症状的家庭成员进行监测。迄今为止,大多数MODY患者仍未得到诊断。为了确定患者的需求以及改善护理的方向,本研究探讨了接受MODY基因检测的患者及其家庭成员的经历。

方法

对患者、患者父母以及有症状和无症状的家庭成员进行了14次半结构式访谈。使用Atlas.ti进行主题分析。

结果

大多数MODY患者最初被误诊为1型或2型糖尿病;他们长期以来一直在寻求正确的诊断。进行基因检测的原因包括获得安心感、消除患糖尿病的不确定性(针对无症状家庭成员)以及告知亲属。反对检测的原因是担心基因歧视以及没有症状。通常,基因检测呈阳性结果并不令人意外。患者和家庭成员都对进行检测的决定感到满意,因为这使他们能够相应地调整生活方式和治疗。所有参与者都感到医疗保健专业人员、他们的社交圈子以及患者组织对MODY缺乏了解。此外,还报告了医疗费用报销方面的问题。

结论

患者和家庭成员总体上对MODY基因检测持积极态度。需要对医疗保健专业人员进行更多教育,糖尿病组织也需要给予更多关注,以提高认识并优化对MODY患者的护理和支持。

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