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Diagnosis, treatment and disclosure: A qualitative exploration of participant challenges in a Monogenic Diabetes Registry

Published:January 19, 2023DOI:https://doi.org/10.1016/j.gim.2023.100019
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      Abstract

      Purpose

      Maturity-onset diabetes of the young (MODY) represents a heterogenous group of monogenic diabetes. Despite its autosomal dominant inheritance, many MODY participants in the University of Chicago Monogenic Diabetes Registry have no family members enrolled. We aimed to gather data on Registry participants’ experiences in 1) receipt of an accurate diagnosis; 2) decisions regarding disclosure of their MODY genetic test results with biological relatives; and 3) recommendations toward our Registry’s processes and outreach.

      Methods

      We conducted 20 one-on-one semi-structured interviews with adult Registry participants.

      Results

      All participants found navigating the healthcare system challenging due to providers’ unfamiliarity with MODY and dismissal of its importance post-diagnosis. All had shared their results with at least one relative, but many found relatives resistant to engaging with their providers. Participants wanted to receive targeted information on their condition and connect with other participants who have faced similar diagnostic and treatment challenges.

      Conclusion

      Our results demonstrate that our probands faced resistance to reclassification of their diabetes from both health care providers and relatives. In an effort to improve cascade testing, the Registry is designing a portal to facilitate participant-research team communication, and to provide additional supports for participants to involve family members in testing.
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