For a long time, insulin injections have simply been a fact of life for people – including babies – suffering from neonatal diabetes. But a new 10-year study has now shown tablets to be just as effective, with recipients hailing the new approach as a "miracle treatment."
Diagnosed in infants less than six months old, neonatal diabetes is a life-threatening condition often caused by a genetic mutation that hampers the performance of insulin-producing cells in the pancreas. It occurs only once in around 300,000 to 400,00 births, but when it does regular injections of insulin, often several times a day can be the only way to keep things in working order. But these have obvious drawbacks.
Fourteen years ago, an international team of scientists kicked off a long-term study investigating whether substituting the injections with sulphonylurea tablets could do the job just as well. This meant enlisting 81 patients from 20 different countries and observing their blood sugar control over a period of 10 years.
Some uncertainty had surrounded the efficacy of sulphonylurea tablets in sufferers of certain types of diabetes. In 2006, scientists at the University of Exeter discovered that around half of neonatal diabetes sufferers could be treated with the tablets instead of injections, but questions remained over the long-term effectiveness. According to those same scientists, these questions have now been answered.
"It was incredibly exciting to help people make the switch from insulin to simple tablets – but the question was, would the benefits last?" says the University of Exeter Medical School's Dr. Pamela Bowman. "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 percent of people in the study remaining on sulphonylureas alone after 10 years, with excellent blood sugar control."
One beneficiary of this new treatment is Jack Matthews, who received insulin injections for his neonatal diabetes up until age four, before switching to the sulphonylurea tablets as part of the study. This has now provided him with a low-maintenance, safe and reliable way to manage his condition.
"It's like we've gone from living in a horror film to living in a rom-com," says Jack's mother, Emma Matthews. "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."
The scientists say the grand success of the study means that the needle-free approach will soon benefit many more.
"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,'" says Professor Andrew Hattersly, the lead of the genetic diabetes research team at the University of Exeter Medical School. "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."
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