Researchers change clinical practice for infants with diabetes
- Date:
- June 7, 2018
- Source:
- The University of Bergen
- Summary:
- Infants with diabetes can drop insulin syringes. This will be new clinical practice after a recent study. Researchers have been leading the work, which causes children worldwide to replace insulin syringes with tablets.
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Infants with diabetes can drop insulin syringes. This will be new clinical practice after a recent study, now published in Lancet Diabetes & Endocrinology. Researchers from Bergen and Exeter have been leading the work, which causes children worldwide to replace insulin syringes with tablets.
"All infants diagnosed with diabetes before 6-7 months of age should be given a rapid gene test to change treatment as soon as possible from insulin to sulfonylurea tablets. They can expect a long and very good effect of the treatment of blood sugar control, and the treatment is safe," says Professor Pål Rasmus Njølstad at the University of Bergen.
It was in 2004 discovered that relatively high doses of sulfonylurea tablets could be used to treat diabetes in infants. This principle has given a new life for children with this type of diabetes, because 90% can stop insulin injections and even achieve better blood sugar control, at least for one year without the same low blood sugar problem. However, it has been unknown whether this treatment can be maintained in the long term, especially as sulfonylureas fail in half of those with type 2 diabetes after five years of treatment.
The results are now available from an international multi-center study from centers in Bergen, Exeter, Rome, Paris, and Krakow. This included 81 people who 10 years ago had changed the treatment from insulin to sulfonylurea tablets. It was found that the failure effect of treatment, which is often seen in type 2 diabetes, rarely exists in this type of infant diabetes. Sulfonylurea is safe in this treatment, even with the relatively high doses needed. An excellent control of blood glucose was retained after ten years of treatment. Some children initially experienced a certain recovery of neurological features, but most of them did not have any clear improvement in the problems.
"These findings will give many children a new and better quality of life," says Njølstad. "This is one of the few examples of lasting effect of precision medicine."
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Materials provided by The University of Bergen. Note: Content may be edited for style and length.
Journal Reference:
- Pamela Bowman, Åsta Sulen, Fabrizio Barbetti, Jacques Beltrand, Pernille Svalastoga, Ethel Codner, Ellen H Tessmann, Petur B Juliusson, Torild Skrivarhaug, Ewan R Pearson, Sarah E Flanagan, Tarig Babiker, Nicholas J Thomas, Maggie H Shepherd, Sian Ellard, Iwar Klimes, Magdalena Szopa, Michel Polak, Dario Iafusco, Andrew T Hattersley, Pål R Njølstad, Javier Aisenberg, Ilker Akkurt, Hussein Abdul-Latif, Anees Al-Abdullah, Lubomir Barak, Joop Van Den Bergh, Anne-Marie Bertrand, Carla Bizzarri, Riccardo Bonfanti, Henri Bruel, Anthony Burrows, Francesco Cadario, Fergus J. Cameron, Dennis Carson, Maryse Cartigny, Vittoria Cauvin, Helene Cave, Ali Chakera, Ravi Chetan, Giovanni Chiari, Bob Couch, Régis Coutant, Elizabeth Cummings, Adriana Dankovcikova, Liz Davis, Dorothee Deiss, Maurizio Delvecchio, Elena Faleschini, Anne-Laure Fauret, Roisin Finn, Tamsin Ford, Elisa De Franco, Bastian De Gallen, Daniela Gasperíková, Padma Guntamukkala, Vaseem Hakeem, Shinji Hasegawa, Eba H. Hathout, Emmeline Heffernan, David Hill, Josephine Ho, Marie Hoarau, Reinhard Holl, Rebecca Hoddinott, Jane Houghton, Neville Howard, Natalie Hughes, Ian Hunter, Anne Kirsti Høgåsen, Helena Kuulasmaa, Sorin Iocara, Violeta Iotova, Henrik Irgens, Alan Jaap, Kenneth Jones, Thomas Kapellen, Ellen Kaufman, Andreas Klinge, Tomasz Klupa, Ramaiyer Krishnaswamy, Tony Lafferty, Laurent LeGault, Paul Lambert, Maciej T Malecki, Olag Malievsky, Revi Mathew, Frances Mathews, Robert McVie, Ulrike Menzel, Chantale Metz, John Van Der Meulen, Gita Modgil, Dick Mul, Silvia Muther, Roos Nuboer, Susan M. O'Connell, Stephen O'Riordan, Miroslav Palko, Kashyap Amratlal Patel, Roberta Pesavento, Elvira Piccinno, Janani Kumaraguru Pillai, Stephanka Pruhova, Zubin Punthakee, Ivana Rabbone, Klemens Raile, Marielisa Rincon, Danette Rose, Janine Sanchez, Susan Sandereson, Vinay Saxena, Martin Schebek, Dorothee Schmidt, Naim Shehadeh, Julian P.H. Shiels, Jose M. C. L Silva, Juraj Stanik, Tracy Tinklin, Erling Tjora, Stefano Tumini, Tiinamaija Tuomi, Akiko Uehara, Robert Van der Velde, Guido Vermeulen, Uma Visser, Paul Voorhoeve, Jan Walker, Jaques Weill, Tobias Weisner, Andrea Werner, Toni Williams, Helen Woodhead, Rønnaug øddegård. Effectiveness and safety of long-term treatment with sulfonylureas in patients with neonatal diabetes due to KCNJ11 mutations: an international cohort study. The Lancet Diabetes & Endocrinology, 2018; DOI: 10.1016/S2213-8587(18)30106-2
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