"Monogenic diabetes - common and needs oral not SC medication"
A recent BBC Inside Health podcast interviewee noted that around 2% of patients with diabetes have a genetic form.1 The point to note is that these people do not need insulin, they need sulfonylurea medications (either in very low or very high doses, depending on the genetic cause of their diabetes) which produces better glucose control than insulin.
Dr Rinki Murphy, a New Zealand expert on this condition, estimates that about 1% of all diabetics are monogenic. There are different subtypes and anyone who has a history of diabetes diagnosed within 6 months of age should be referred for genetic testing.
Monogenic diabetes should also be considered in those diagnosed under 25 years, with a strong family history of diabetes (either antibody negative type 1 diabetes or atypical type 2 diabetes) and without hypertension or dyslipidemia).
Getting advice on whom to test is important. The NZSSD have an article on this topic2 and there is an app.3
This gem has been checked by Dr Rinki Murphy, Diabetes Specialist Greenlane and Middlemore Hospitals and Mercy Specialist Centre, ph (09) 623 1170. Email: firstname.lastname@example.org
- BBC Inside Health-personalised medicine. Click here
- NZSSD guidelines for monogenic diabetes. Click here
- Diabetes Diagnostics (University of Exeter) app on iTunes.
Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.