Increasing Awareness and Identification of Maturity-Onset Diabetes of the Young in a Pediatric Diabetes Program
Raymond J. Kreienkamp, Jessica L. Ruiz, Sarah Schlegel, Olivia Sterns, Jia Zhu, Tara Maxwell, Christine E. Cherella, Erinn T. RhodesIntroduction:
Maturity-onset diabetes of the young (MODY) is frequently misdiagnosed, but an accurate diagnosis can inform tailored diabetes management. A quality improvement project was launched in 2022 at a pediatric tertiary care center to (1) increase MODY testing among individuals with islet autoantibody-negative (IAb−) new-onset diabetes mellitus (NODM) and (2) increase provider awareness of MODY.
Methods:
Interventions targeted the primary drivers, including provider recognition of MODY and barriers to testing. Each month, an electronic medical record report identified patients with IAb− NODM diagnosed within the prior 3 months. A standardized previsit email was sent to the treating provider that (1) flagged IAb− status, (2) outlined MODY testing criteria, and (3) provided instructions for ordering genetic testing when indicated. The primary outcome, MODY tests ordered among eligible patients, was analyzed longitudinally using a control chart. Provider awareness of MODY and perceptions of the intervention were assessed in May 2023 and March 2024.
Results:
The proportion of patients with IAb− NODM tested for MODY at a clinic visit within 365 days of diagnosis increased from 2.87% at baseline (January/February 2021–May/June 2022) to 9.94% after the quality improvement project launch in July/August 2022. Among completed tests through October 2025, 9 of 28 (32.1%) identified a pathogenic or likely pathogenic MODY variant. Providers’ familiarity with MODY testing criteria also improved, with those reporting being “extremely familiar” increasing from 0% (0/20) to 17% (3/18).
Conclusions:
The project, including the targeted previsit provider email, was associated with increased MODY testing and improved provider awareness in a pediatric diabetes clinic.