What is the most likely diagnosis?

A 16-year-old boy was referred to the diabetes clinic following the discovery of a random plasma glucose concentration of 18.0 mmol/L. His general practitioner had begun treatment with metformin. The patient had a body mass index of 35 kg/m2 (18C25). He had had problems throughout his childhood, and had been taken out of school and was educated at home by his mother. He was attending the ophthalmology clinic for visual problems.

On examination, he was obese. He had hearing aids in both ears and evidence of acanthosis nigricans. Neither parent had a history of diabetes mellitus.

What is the most likely diagnosis?
A . Alström’s syndrome
B . BardetCBiedl syndrome
C . hepatocyte nuclear factor 1? mutation
D . mitochondrial diabetes
E . type 2 diabetes mellitus

Answer: A

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