The c.1368del variant in the glucokinase gene, GCK, causes a frameshift in the protein at codon 457 (NM_000545.6), adding 157 novel amino acids before encountering a stop codon (p.(Cys457Valfs157)). This variant, located in exon 10 of 10, is predicted to cause loss of a stop codon and result in an elongated protein. The additional residues are expected to cause improper folding, resulting in loss of function in a gene in which loss-of-function is an established disease mechanism (PVS1; PMID 19790256). This variant is absent from gnomAD 2.1.1 (PM2_Supporting). In summary, c.1368del meets the criteria to be classified as likely pathogenic for monogenic diabetes. ACMG/AMP criteria applied, as specified by the ClinGen MDEP (specification version 1.2.0, approved 6/7/2023): PVS1, PM2_Supporting.