Heart and Cholesterol

Of everything in this category, cardiovascular health is the part that applies to you regardless of which gene you carry.

Even in GCK-MODY, where macrovascular complications occurred in only 4% against 30% in Type 2 diabetes, blood pressure and cholesterol still matter — because they are risk factors in their own right, not merely consequences of diabetes.

So while your glucose management depends heavily on your subtype, your cardiovascular management largely does not.

What that means in practice: blood pressure checked at every visit with a target agreed for you, a lipid panel periodically, and a conversation about whether statin treatment applies given your overall risk.

Not smoking sits above everything else on that list.

There is a specific Indian dimension. South Asians develop cardiovascular disease at lower body weight and waist size than white Europeans, which is why India uses its own thresholds — overweight from a BMI of 23, and abdominal obesity from a waist above 90 cm in men and 80 cm in women. A waist measurement is therefore worth tracking even where your glucose needs no attention at all.

This is also the area where the general healthy-eating and activity advice earns its place in monogenic diabetes, having limited effect on your glucose in some subtypes but a real effect here.

Ask what your blood pressure and cholesterol targets are, and whether you are meeting them.