▁ ▁Moreover , ▁half ▁of ▁T ND M ▁patients ▁that ▁contain ▁chrom os ome ▁ 6 q 2 4 - related ▁T ND M ▁experien cing ▁re - occ urrence ▁of ▁di ab etes ▁during ▁their ▁child hood ▁or ▁young ▁ad ul th ood . ▁The ▁on set ▁of ▁ins ul in ▁resistance ▁and ▁increased ▁ins ul in ▁requirements ▁are ▁associated ▁with ▁pub ert y ▁and ▁pre gn ancy ▁initi ating ▁the ▁re lapse ▁of ▁di ab etes . ▁In ▁the ▁event ▁of ▁rem ission , ▁individuals ▁do ▁not ▁show ▁sympt oms ▁or ▁imp air ment ▁B eta - cell ▁function ▁in ▁the ▁fast ing ▁state . ▁Ins ul in ▁secret ory ▁response ▁to ▁int ra ven ous ▁gl uc ose ▁loading ▁might ▁be ▁ab normal ▁in ▁those ▁dest ined ▁to ▁have ▁a ▁re lapse ▁of ▁di ab etes . ▁ ▁T ND M ▁caused ▁by ▁ 6 q 2 4 ▁genom ic ▁defect s ▁are ▁always ▁associated ▁with ▁I G UR . ▁Other ▁contrib uting ▁factors ▁are ▁um bil ical ▁h ern ia ▁and ▁en larg ed ▁tongue , ▁which ▁are ▁present ▁in ▁ 9 ▁and ▁ 3 0 % ▁of ▁patients ▁with ▁chrom os ome ▁ 6 q 2 4 ▁related ▁T ND M . ▁ ▁K CN J 1 1 ▁and ▁AB CC 8 ▁Gen es ▁ ▁In ▁addition , ▁T ND M ▁initi ated ▁by ▁the ▁gen es , ▁K CN J 1 1 ▁or ▁AB CC 8 ▁mut ations ▁are ▁similar ▁to ▁mut ations ▁in ▁chrom os ome