I changed endocrinologists recently as my prior doc was, well let me say this nicely... arrogant and it was his way or not at all. So I left as his patient. He diagnosed me as a type 2. My new doc is convinced I am a MODY.He spent 2 hours with me on the initial visit doing a complete history, and even though there is no diabetes in my family, all members have thyroid disease. I am thin (had lost weight) and maintained through low-carb, diet and medication and in the last 4 years have retained the same weight with a BMI of 18-19. I had been taking metformin but it wasn't working well anymore. My new doc put me on glimiperide (1-2 per day and metformim) and that has made a big difference! I have actually been able to add a bit more good carb but still keep it under 60 per day. He said that this medication is very effective for MODY's. What are others taking? I am most likely a MODY 3 and may have genetic tests when the $$$ is available. (NOT) At any rate, I was getting frustrated as I saw and heard many type 2's who did less than I did get off meds when I was having to up mine!So what works? I do low carb and plan to stay with that plan. I exercise every day,mixing it up with hiking, biking, walking, pilates and yoga. Other than go vegan or vegetarian which is really hard and I have done it with significant weight loss and find that I need to eat protein so I do eat fish, chicken, etc. I have found this site most helpful and Dr. Bernstein's book put me on the right track. I have found the ADA diets not to be very good. So,just learning more now about MODY and how I can best deal with this diagnosis and live as healthy as I am able. Thanks.
I don't know if I'm MODY or not. Maybe one day I will be able to afford testing. My brother also was diagnosed with diabetes while young and normal weight. My Metformin is working for my currently, but it hasn't quite been a year since diagnosis so who knows what's going to happen. I take 1500mg per day. My BMI is 19 also.
Personally, I don't know if I'd take a sulfonylurea class drug, such as glimeperide. If I were LADA, I think I would skip oral meds and just start insulin, but since the progression of beta cell burn out can be much slower in MODY, I might consider taking a sulfonylurea for awhile. I do believe that taking a drug that forces the beta cells to make more insulin will cause them to burn out more quickly
On the subject of sulfonylureas vs insulin for MODY, it's probably worth noting that beta cell burn-out is not the only thing to take into consideration when thinking about the long-term effects of different treatment options; many MODY patients find that they actually get better control from sulphonylureas than from insulin, which would of course reduce the risk of complications in the long term.
Note: I'm not a doctor and I don't know anything about beta-cell burnout. I do know that good control is always better in the long run though, and MODY patients are vulnerable to complications just like other patients with diabetes.
Jenny Ruhl over at BloodSugar 101 has had good luck with sulfonylureas like Glimeperide in treating her MODY-3. Jenny claims that a hallmark of MODY-3 is that you dump sugar in your urine at lower levels. Normally, when your blood sugar hits about 180 mg/dl you start to dump sugar, but in MODY-3 you start to dump at about 140 mg/dl.
In MODY-3, the beta cells are perfectly fine, they have an abundance of beta-cell function, but the signalling is messed up. I would have less worry that a sulfonylureas would "burn out" my beta cells if I had a confirmed MODY-3 diagnosis. In a T2, they have already lost 80% of their beta cell function when they are diagnosed and studies seem to suggest that treatment with sulfonylureas results further decine (other drugs don't result in such decline).
Thanks for the information! Very helpful in regards to the "burn-out" issue which concerns me with the sulfonylureas.
bsc, you do have a link to an article regarding beta cell function in MODY3? I'm not questioning you, I'm just curious and want to learn more about MODY3. I had read in another article that MODY3 is characterized by decreased insulin secretion and their mice studies suggested that sulfonylureas were effective because of decreased hepatic clearance of the drugs leading to increased plasma concentrations. Of course, it may not work the same way in humans, but it was still interesting.
Have you looked through the resource section here?
There are a couple of good presentations that detail the various MODY - some include charts comparing insulin secretion in response to glucose.
I just saw the resource thread, not sure how I missed that! I will definitely go through and check out all the links.
Here is a link you might be interested in: