Successful maintenance on sulphonylurea therapy and low diabetes complication rates in a HNF1A–MODY cohort

Abstract

This study demonstrates that the majority of patients with HNF1A-MODY can be maintained successfully on sulphonylurea therapy with good glycaemic control. We note a significantly lower rate of micro- and macrovascular complications than reported previously. The use of appropriate therapy at early stages of the disorder may decrease the incidence of complications.

Monogenic Diabetes in Children and Adolescents: Recognition and Treatment Options

“…Prevalence of microvascular complications in HNF1A-MODY is strongly related to glycemic control. Patients managed appropriately have lower rates of complications [20]. …”

“…This seems to be related to a delay in initiating SUs as well as weight gain [20]. The best alternative treatment regimen is not clear, but options include adding basal insulin, GLP-1 agonists, or metformin to SUs.…”

Maturity onset diabetes of the young: Diagnosis and treatment options

“…The HbA1c in the HNF1a-MODY group treated with sulfonylurea therapy alone improved significantly over the study period. The rate of retinopathy was significantly lower in the HNF1a-MODY group than that in the T1DM group as well as a lower rate of microalbuminuria and cardiovascular disease [68].…”

“…The patient should be monitored carefully since the disease is not always stable and additional lines of therapy may be helpful in future [67]. Still it is considered that approximately 70-80% of patients can successfully be treated with sulfonylureas with no insulin injections [46,48,68]. Some patients on the other hand remain on insulin treatment due to complications [48].…”

Incremental cost-effectiveness of algorithm-driven genetic testing versus no testing for Maturity Onset Diabetes of the Young (MODY) in Singapore

“…Shepherd et al 4 and Thanabalasingham et al 6 reported an HbA1c fall of 0.8%–1.5% in small numbers of patients (n=6–8 per study) following a switch to sulfonylurea therapy, but follow-up was limited to an average of 3 months in one study6 and a median duration of 6 months in the other 4. Bacon et al 29 did not find a significant fall in HbA1c when switching patients with HNF1A MODY from insulin to sulfonylureas. Therefore, we did not model better glycaemic control as an outcome of MODY testing.…”