Successful maintenance on sulfonylurea therapy and low diabetes complication rates in a HNF1A-MODY cohort

2.50
Hdl Handle:
http://hdl.handle.net/11287/593964
Title:
Successful maintenance on sulfonylurea therapy and low diabetes complication rates in a HNF1A-MODY cohort
Authors:
Bacon, S.; Kyithar, M. P.; Rizvi, S. R.; Donnelly, E.; McCarthy, A.; Burke, M.; Colclough, Kevin; Ellard, Sian ( 0000-0002-7620-5526 ) ; Byrne, M. M.
Abstract:
AIMS: HNF1A gene mutations are the most common cause of maturity-onset diabetes of the young (MODY) in the UK. Persons with HNF1A-MODY display sensitivity to sulfonylurea therapy; however, the long-term efficacy is not established. There is limited literature as to the prevalence of micro- and macrovascular complications in this unique cohort. The aim of this study was to determine the natural progression and clinical management of HNF1A-MODY diabetes in a dedicated MODY clinic. METHODS: Sixty patients with HNF1A-MODY and a cohort of 60 BMI-, age-, ethnicity- and diabetes duration-matched patients with Type 1 diabetes mellitus participated in the study. All patients were phenotyped in detail. Clinical follow-up of the HNF1A-MODY cohort occurred on a bi-annual basis. RESULTS: Following a genetic diagnosis of MODY, the majority of the cohort treated with sulfonylurea therapy remained insulin independent at 84-month follow-up (80%). The HbA1c in the HNF1A-MODY group treated with sulfonylurea therapy alone improved significantly over the study period [from 49 (44-63) mmol/mol, 6.6 (6.2-7.9)% to 41 (31-50) mmol/mol, 5.9 (5-6.7)%; P = 0.003]. The rate of retinopathy was significantly lower than that noted in the Type 1 diabetes mellitus group (13.6 vs. 50%; P = 0.0001).There was also a lower rate of microalbuminuria and cardiovascular disease in the HNF1A-MODY group compared with the Type 1 diabetes mellitus group. CONCLUSIONS: This study demonstrates that the majority of patients with HNF1A-MODY can be maintained successfully on sulfonylurea 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.
Citation:
Diabet Med. 2016 33(7) 976-84
Publisher:
Wiley
Journal:
Diabetic medicine : a journal of the British Diabetic Association
Issue Date:
17-Nov-2015
URI:
http://hdl.handle.net/11287/593964
DOI:
10.1111/dme.12992
PubMed ID:
26479152
Additional Links:
http://dx.doi.org/10.1111/dme.12992
Type:
Journal Article
Language:
Eng
ISSN:
1464-5491
Appears in Collections:
2015 RD&E publications; Molecular Genetics; Molecular Genetics

Full metadata record

DC FieldValue Language
dc.contributor.authorBacon, S.en
dc.contributor.authorKyithar, M. P.en
dc.contributor.authorRizvi, S. R.en
dc.contributor.authorDonnelly, E.en
dc.contributor.authorMcCarthy, A.en
dc.contributor.authorBurke, M.en
dc.contributor.authorColclough, Kevinen
dc.contributor.authorEllard, Sianen
dc.contributor.authorByrne, M. M.en
dc.date.accessioned2016-01-19T12:38:02Zen
dc.date.available2016-01-19T12:38:02Zen
dc.date.issued2015-11-17en
dc.identifier.citationDiabet Med. 2016 33(7) 976-84en
dc.identifier.issn1464-5491en
dc.identifier.pmid26479152en
dc.identifier.doi10.1111/dme.12992en
dc.identifier.urihttp://hdl.handle.net/11287/593964en
dc.description.abstractAIMS: HNF1A gene mutations are the most common cause of maturity-onset diabetes of the young (MODY) in the UK. Persons with HNF1A-MODY display sensitivity to sulfonylurea therapy; however, the long-term efficacy is not established. There is limited literature as to the prevalence of micro- and macrovascular complications in this unique cohort. The aim of this study was to determine the natural progression and clinical management of HNF1A-MODY diabetes in a dedicated MODY clinic. METHODS: Sixty patients with HNF1A-MODY and a cohort of 60 BMI-, age-, ethnicity- and diabetes duration-matched patients with Type 1 diabetes mellitus participated in the study. All patients were phenotyped in detail. Clinical follow-up of the HNF1A-MODY cohort occurred on a bi-annual basis. RESULTS: Following a genetic diagnosis of MODY, the majority of the cohort treated with sulfonylurea therapy remained insulin independent at 84-month follow-up (80%). The HbA1c in the HNF1A-MODY group treated with sulfonylurea therapy alone improved significantly over the study period [from 49 (44-63) mmol/mol, 6.6 (6.2-7.9)% to 41 (31-50) mmol/mol, 5.9 (5-6.7)%; P = 0.003]. The rate of retinopathy was significantly lower than that noted in the Type 1 diabetes mellitus group (13.6 vs. 50%; P = 0.0001).There was also a lower rate of microalbuminuria and cardiovascular disease in the HNF1A-MODY group compared with the Type 1 diabetes mellitus group. CONCLUSIONS: This study demonstrates that the majority of patients with HNF1A-MODY can be maintained successfully on sulfonylurea 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.en
dc.language.isoEngen
dc.publisherWileyen
dc.relation.urlhttp://dx.doi.org/10.1111/dme.12992en
dc.titleSuccessful maintenance on sulfonylurea therapy and low diabetes complication rates in a HNF1A-MODY cohorten
dc.typeJournal Articleen
dc.identifier.journalDiabetic medicine : a journal of the British Diabetic Associationen

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