'Miracle treatment' long-term success for babies with diabetes

June 4, 2018, University of Exeter

Over a decade, Emma Matthews has progressed from fearing for her son's life every night to being safe in the knowledge that his diabetes is well managed thanks to the long-term success of "miracle treatment" tablets.

Until he was four, Jack frequently had life-threatening low blood sugar (hypos) at night as a result of the he took several times a day to treat his neonatal diabetes. He was among the first to switch from insulin injections to sulphonylurea tablets 14 years ago, thanks to research led by the University of Exeter 'involving an international collaboration with groups in Norway, Italy, France and Poland. . Today, the team's new research in The Lancet Diabetes and Endocrinology reveals that the treatment is just as successful over the long-term and still providing excellent sugar control after 10 years.

Neonatal diabetes is diagnosed before the age of six months. Half of all cases are caused by a mutation in their KCNJ11 gene—which is involved in keeping insulin-producing cells in the pancreas working properly. This results in life threatening diabetes soon after birth. Led by the University of Exeter, the new decade-long analysis of 81 patients from 20 different countries was funded by the Wellcome Trust and Diabetes UK. It shows that these people can be treated successfully through sulphonylurea tablets, with excellent in the long term.

Professor Andrew Hattersley is the lead of the genetic diabetes research team at the University of Exeter Medical School. In 2006, they discovered that around half of people with neonatal diabetes can come off insulin injections and be treated more effectively with sulphonylurea tablets. In these people, the tablets provide the key to unlocking the closed door of the insulin-producing beta cells.

Professor Hattersley 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 with 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."

Dr. Pamela Bowman, of the University of Exeter Medical School, who led the study, said: "It was incredibly exciting to help people make the switch from insulin to simple tablets—but the question was, would the benefits last? Half of people with type 2 diabetes treated with sulphonylureas no longer have good blood sugar control after five years. Our study has found that in neonatal diabetes, the tablets are safe and they work long term—with 93% of people in the study remaining on sulphonylureas alone after 10 years, with excellent blood sugar control."

Today, Jack's diabetes is so well managed that Emma has not had to worry about his condition since he changed treatment.

"It's like we've gone from living in a horror film to living in a rom com," said Emma, a nurse from Essex in the UK. "Before Jack switched treatment, every single night was a living nightmare. His blood sugar levels were all over the place, and I didn't think he was going to be alive when I went into his bedroom in the morning."

Now, Jack has recently celebrated his 18th birthday, with 150 guests. "We're so proud of our charming young man," said Emma. "He makes friends wherever he goes. Dealing with Jack's diabetes was particularly hard because of his severe learning difficulties. I honestly don't think he'd still be with us if it wasn't for the research at Exeter."

Dr. Elizabeth Robertson, Director of Research at Diabetes UK, said: "It's so important that people living with rare forms of diabetes, like neonatal diabetes, receive the right diagnosis and treatment. That's why we are delighted to have been able to help fund this vital work, demonstrating for the first time that sulphonylurea tablets are a safe and effective way for some people with neonatal diabetes to manage their condition for the long term. Moving forward, we hope research will uncover ways to prevent the developmental issues people with neonatal diabetes face.

"Nine out of ten with this condition can switch from therapy when they get the right diagnosis, so we would like all children diagnosed with under six months to be tested for , so the right can help them get the best start in life."

Explore further: Type 1 diabetes as common in adults as children, but many adults misdiagnosed

More information: The paper, 'Effectiveness and safety of long-term treatment with sulphonylureas in neonatal diabetes due to KCNJ11 mutations: an international cohort study' is published in The Lancet Diabetes and Endocrinology: www.thelancet.com/journals/lan … (18)30106-2/fulltext

Related Stories

Type 1 diabetes as common in adults as children, but many adults misdiagnosed

November 30, 2017
Type 1 diabetes is not predominantly a 'disease of childhood' as previously believed, but is similarly prevalent in adults, new research published in the Lancet Diabetes & Endocrinology shows.

Scientists discover new causes of diabetes

January 7, 2014
Research by the University of Exeter Medical School has revealed two new genetic causes of neonatal diabetes.

Genomic testing triggers a diabetes diagnosis revolution

August 17, 2015
Over a 10 year period, the time that babies receive genetic testing after being diagnosed with diabetes has fallen from over four years to under two months. Pinpointing the exact genetic causes of sometimes rare forms of ...

Transforming skin cells to insulin

August 9, 2017
Researchers at the University of Bergen have transformed skin puncture cells from diabetes patients into insulin producing cells, using stem cell techniques. The researchers' aim is to transplant these cells under the skin ...

Diabetes gene found that causes low and high blood sugar levels in the same family

January 15, 2018
A study of families with rare blood sugar conditions has revealed a new gene thought to be critical in the regulation of insulin, the key hormone in diabetes.

Sugar sponges sop up and release glucose as needed

May 31, 2017
Many diabetes patients must inject themselves with insulin, sometimes several times a day, while others take medications orally to control blood sugar. The injections, as well as the side effects from both regimens, can be ...

Recommended for you

Using mushrooms as a prebiotic may help improve glucose regulation

August 16, 2018
Eating white button mushrooms can create subtle shifts in the microbial community in the gut, which could improve the regulation of glucose in the liver, according to a team of researchers. They also suggest that better understanding ...

Cardiovascular disease related to type 2 diabetes can be reduced significantly

August 16, 2018
Properly composed treatment and refraining from cigarette consumption can significantly reduce the risk of cardiovascular disease resulting from type 2 diabetes, according to a study published in the New England Journal of ...

Blood test may identify gestational diabetes risk in first trimester

August 16, 2018
A blood test conducted as early as the 10th week of pregnancy may help identify women at risk for gestational diabetes, a pregnancy-related condition that poses potentially serious health risks for mothers and infants, according ...

Weight gain after smoking cessation linked to increased short-term diabetes risk

August 15, 2018
People who gain weight after they quit smoking may face a temporary increase in the risk of developing type 2 diabetes, with the risk directly proportional to the weight gain, according to a new study from Harvard T.H. Chan ...

Evening preference, lack of sleep associated with higher BMI in people with prediabetes

August 15, 2018
People with prediabetes who go to bed later, eat meals later and are more active and alert later in the day—those who have an "evening preference"—have higher body mass indices compared with people with prediabetes who ...

Healthy fat cells uncouple obesity from diabetes

August 14, 2018
About 422 million people around the world, including more than 30 million Americans, have diabetes. Approximately ninety percent of them have type 2 diabetes. People with this condition cannot effectively use insulin, a hormone ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.