Tablets shown to be a strong replacement for insulin in treating neonatal diabetes

Jack Woodfield
Tue, 05 Jun 2018
Tablets shown to be a strong replacement for insulin in treating neonatal diabetes
Babies with neonatal diabetes can be safely and effectively treated with tablets instead of injections, new research suggests.

Neonatal diabetes is a rare diabetes type that affects babies under the age of six months. It is a genetic disorder that often requires either treatment with insulin or a drug called glibenclamide, part of the sulphonylurea class.

Because injecting babies with insulin can be deeply unpleasant, research has geared towards making tablet treatment the more common practice.

Scientists from the University of Exeter and from all over Europe conducted a 10-year follow-up study of 81 patients from 20 countries, all of whom were diagnosed with neonatal diabetes and switched from receiving insulin injections to high doses of sulphonylurea.

The study began in 2006, and at the end of follow-up researchers observed that sulphonylurea led to strong long-term blood sugar control. Before the switch to sulphonylurea treatment, the participants' average HbA1c was 65 mmol/mol (8.1%). After 10 years of sulphonylurea treatment, their average HbA1c was 46 mmol/mol (6.4%), which represents an excellent improvement in blood glucose control.

Only mild side effects were observed following the switch, but none of the patients needed to cease therapy. No reports of severe hypoglycemia - a potential complication of sulphonylurea - were recorded.

Study author Professor Andrew Hattersley, from the University of Exeter Medical School, said: "Switching from regular insulin injections was life-changing for these people who had been on insulin all their life; many described it as 'a miracle treatment'.

"Not only does this eradicate the need to inject insulin several times a day, it also means much better blood sugar control.

"This is the first study to establish that this treatment is safe and works excellently for at least 10 years, and all indications are that it will continue to work for decades more. This is great news for the thousands of patients who have made the switch from insulin."

Benedict Jephcote, Editor of Diabetes.co.uk, said: "To get such a strong and sustained improvement in HbA1c levels is an amazing result. This can help to significantly delay or prevent complications and is likely to greatly improve quality of life for people with this form of diabetes."

The findings have been published in The Lancet Diabetes and Endocrinology.
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