Rare diabetes type called MODY 1 needs alternative treatment, say researchers

[DCUK NewsBot]

Patients who are treated for a rare, genetic form of diabetes which has the same symptoms as type 2 diabetes could have damaged insulin-secreting beta cells, research finds. This rare diabetes type is called maturity-onset diabetes of the young (MODY1). MODY1 is directly caused by a change in a single gene, Hepatic Nuclear Factor 4 Alpha (HNF4A). All children of a parent with this rare form of diabetes have a 50 per cent risk of inheriting this gene. MODY 1 develops before the age of 25 and shares similar symptoms to type 2 diabetes, although it is not linked to obesity. Patients are at an increased risk of getting misdiagnosed with type 2 diabetes, and this can affect their treatment plan. Researchers at the Washington University School of Medicine suggest that guidelines for MODY 1 treatment need to change. Lead author Benjamin D. Moore, PhD, a former postdoctoral fellow at Washington University who is now at Massachusetts General Hospital, said that patients with MODY 1 often start out with oral medication, such as sulphonylureas, and then move on to insulin injections within 10 years of diagnosis. This treatment is designed to keep blood glucose levels under control, but their findings show that oral medications increase cellular stress levels of insulin-producing beta cells. This eventually kills the beta cells, and necessitates the switch to insulin injections. "People diagnosed with type 2 diabetes are treated with oral medications that make insulin-secreting beta cells very active. But the MODY 1 pathway we've uncovered shows that stimulating those cells with those drugs can lead to beta cell death. That means these patients can become dependent on insulin injections much sooner," said Moore. Alongside his study partner, Jason C. Mills, MD, PhD, associate professor of medicine at Washington University, Moore concluded that patients with MODY 1 could instead benefit from treatment that targets specific pathways which are crucial to beta cell functionality. Moore and Mills added that doctors need to be certain a patient has MODY 1 before commencing treatment. "It's important to diagnose patients as accurately as possible and to attempt to target the correct pathway," Moore said. Mills' laboratory is now trying to assess if insulin-secreting pathways which are disrupted in MODY are active in different types of secretory cells. The findings appear in The Journal of Biological Chemistry.

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[Robinredbreast]

Today I met a nice young woman, who has MODY. It was really interesting talking to her, she told me her mother was diagnosed with Type 1 and on Insulin. Both the young woman and her sister have been diagnosed with MODY and tablets are taken with her meals to stop the BG from escalating. Because it is in the family, only the girls have it, the mother was re diagnosed as MODY, but because of taking Insulin for years, she still has to take it.

 

[desidiabulum]

Sorry -- I kept hitting the wrong button for replies. I was just puzzled by the report. What is the point of saying that MODY1 sufferers require 'alternative treatment' without specifying what such a treatment might be? I think the point that sulphonylureas like gliclazide gradually destroy beta cells is fairly well known -- all the more reason to try to control BGs without them if at all possible (doesn't seem possible for me alas).

 

[Robinredbreast]

Sorry -- I kept hitting the wrong button for replies. I was just puzzled by the report. What is the point of saying that MODY1 sufferers require 'alternative treatment' without specifying what such a treatment might be? I think the point that sulphonylureas like gliclazide gradually destroy beta cells is fairly well known -- all the more reason to try to control BGs without them if at all possible (doesn't seem possible for me alas).

The young woman I was talking to was put on Metformin, but it wasn't helping her, she is on a medication, but I cant remember the full name, starts with a D.

 

[desidiabulum]

Today I met a nice young woman, who has MODY..

Everyone with MODY is nice, apparently.(!)

 

[Robinredbreast]

Everyone with MODY is nice, apparently.(!)

She was with my son, and she is a 'friend' we met, when I was visiting my dad in the care home, nice person to talk to. Small world.

 

[tim2000s]

@Robinredbreast It wasn't dapagliflozin was it?

 

[Robinredbreast]

@Robinredbreast It wasn't dapagliflozin was it?

Thank you, but unsure Tim ( it got a little noisy) it was definitely a D though, I tried to google, but couldn't see anything significant.

 

[Down-Jai 001]

Today I met a nice young woman, who has MODY. It was really interesting talking to her, she told me her mother was diagnosed with Type 1 and on Insulin. Both the young woman and her sister have been diagnosed with MODY and tablets are taken with her meals to stop the BG from escalating. Because it is in the family, only the girls have it, the mother was re diagnosed as MODY, but because of taking Insulin for years, she still has to take it.

I was diagnosed for T2,20 years ago,used in insulin 4-6 units in 2016just in evening.It seems there's no chance to reversible it,unlike T2.