The type 2 diabetes drug Victoza could be used to treat people with the most common form of a rarer type of diabetes called MODY.
MODY stands for maturity-onset diabetes of the young and is a genetic condition which causes higher than normal blood glucose levels. The form of MODY being treated in the study is a form called hepatocyte nuclear factor 1-alpha, also known as HNF1A or MODY3. This form of MODY is the most common form, affecting around 70% of people diagnosed with MODY.
Whilst HNF1A is present from birth, it is not usually diagnosed until adolescence or into adulthood. Because HNF1A is relatively rare and shares similarities with more common forms of diabetes, it can be incorrectly diagnosed as either type 1 or type 2 diabetes. To date, a class of drugs called sulfonylureas are usually used to treat HNF1A diabetes.
Whilst sulfonylureas have proved to be successful at treating this form of MODY, researchers from the University of Copenhagen in Denmark were keen to test a newer type of diabetes drug to see if it has potential to work as a treatment for HNF1A.
The research involved a 6 week study of 16 patients (half male, half female) with HNF1A. Patients varied in age between 23 and 67 years of age and had similar BMI values of around 24.9, similar HbA1c results around 47 mmol/mol (6.4%) and similar fasting plasma glucose levels of around 9.9 mmol/l. The researchers tested glimepiride (marketed as Amaryl) in the sulfonylureas drug class against liraglutide (Victoza) in a relatively new class of injectable drugs known as GLP-1 receptor agonists.
The results of the study showed that both glimepiride and the newer diabetes drug, Victoza, were able to reduce blood glucose levels to a lower level than at the start of the study. Glimepiride reduced both fasting and post meal blood glucose levels by a larger amount than Victoza, for example glimepiride reduced fasting plasma glucose levels by 2.8 mmol/l compared with the start of the study, whilst Victoza treatment saw a decrease of 1.6 mmol/l.
Whilst glimepiride performed better at reducing blood glucose levels, Victoza was associated with a much lower rate of hypoglycemia. During the six week study 18 episodes of hypoglycemia were recorded within the glimepiride treatment compared with just one episode of low blood sugar within the Victoza treatment.
The results show promise for the use of GLP-1 receptor agonists, such as Victoza, Byetta and Bydureo, in the treatment of HNF1A diabetes particularly if regular hypoglycemia is an issue. The study was only a small study and further, larger studies will be required to prove that GLP-1 receptor agonists are a suitable treatment for MODY3.

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