Infants born with a rare form of inherited diabetes might avoid irreversible damage to their pancreases if they are treated immediately with sulfonylurea drugs rather than insulin, according to a new report in the February 4th issue of Cell Metabolism, a Cell Press publication.
The researchers confirmed in studies of mice that the disease results from a defect of potassium channels in the pancreas that normally serve as the link between glucose metabolism and insulin release. In those with the mutations, the channels fail to close in response to glucose as they usually would. Sulfonylurea drugs that have been used in the treatment of type 2 diabetes restore function and reverse disease symptoms by blocking those channels, they found.
If the disease is caught early enough, their findings suggest that the drug therapy may circumvent secondary damage to insulin-producing ? cells in the pancreas that is caused by poor blood sugar control.
" The major clinical consequence [for people with neonatal diabetes] is a switch in therapy from insulin treatment for life to sulfonylurea drugs that block this channel. It's potentially a magic bullet treatment," said Colin Nichols of Washington University School of Medicine.
The researchers earlier found that mice with "overactive" potassium channels throughout their bodies develop profound neonatal diabetes. However, those mice died shortly after birth, preventing further study of how the disease would progress.
Those findings nevertheless predicted the human disease, Nichols said. Indeed, it's now known that mutations of the potassium channels are the most common cause of neonatal diabetes.