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Simple Home Urine Test Measures Insulin Production In Diabetes Patients

Discussion in 'Research' started by madde, Mar 2, 2011.

  1. madde

    madde Approved members

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    Simple Home Urine Test Measures Insulin Production In Diabetes Patients
    Main Category: Diabetes
    Also Included In: Pediatrics / Children's Health; Medical Devices / Diagnostics
    Article Date: 26 Feb 2011 - 0:00 PST


    A single home urine test which can be sent by post may replace multiple blood tests in hospital - the test measures whether or how much insulin is being produced by individuals with diabetes Type 1 and Type 2. The test kit was developed by Professor Andrew Hattersley and team from the The Peninsula College of Medicine and Dentistry, Exeter, England. Children especially will benefit from not having to undergo blood tests, the researchers said.

    Patient insulin-production is measured regardless of whether they are taking insulin injections. The tests can be used to differentiate diabetes Type 1 from Type 2, plus other rare genetic forms of the disase. An accurate diagnosis is crucial when deciding on whether to alter treatment, or even to discontinue the insulin.

    For example, Jillian, aged 35, was diagnosed with diabetes 16 years ago and prescribed insulin injection. The home urine test found that she was producing her own insulin at the age of 33. A DNA test found that she had a genetic type of diabetes. She is no longer on insulin injections.

    "Being told I don't have to take insulin injections any more has changed my life", she said.

    The key studies, led by Dr Rachel Besser and Dr Angus Jones and were funded by Diabetes UK and the National Institute of Health Research, are published in leading diabetes journals, Diabetes Care and Diabetic Medicine.

    Dr Rachel Besser, who has led the studies on over 300 patients, commented: "The urine test offers a practical alternative to blood testing. As the urine test can be done in the patients own home we hope that it will be taken up more readily, and more patients can be correctly diagnosed and be offered the correct treatment".

    Dr. Iain Frame, Director of Research at leading health charity Diabetes UK, said: "Dr. Besser's research is an excellent example of Diabetes UK's commitment to fund scientists at the beginning of their careers in diabetes research. With growing numbers of people with diabetes, it's more important than ever to ensure that medically trained graduates are encouraged to enter the field of diabetes research to help improve the lives of people with the condition. Many aspects of diabetes, from diagnosis to treatment, are invasive. Therefore, we welcome Dr. Besser's research and look forward to further developments."

    Source:
    Andrew Gould
    The Peninsula College of Medicine and Dentistry

    My question is what type of diabetes did this now 35 year old have when she was diagnosed at 19 and taken off of insulin 16 years later????
     
  2. TheFormerLantusFiend

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    Since a genetic test confirmed it, it was MODY. MODY accounts for maybe 2% of all cases of diabetes (autoimmune type 1 is about 10% and type 2 is about 85%).
    I have also known people with more common. type 2 diabetes diagnosed at ages 12-25 with type 1 rediagnosed type 2 and taken off insulin.
     
  3. madde

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    Thanks for clarifying that for me!

    I was under the impression that those diagnosed with MODY would still require insulin but less than someone with type 1? Or, they would initially start out not needing insulin, but would require insulin eventually. Is that not the case?

    Thanks for your input.
     
  4. rebesser

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    Dear Elizabeth

    It depends on the type of MODY - there are several different types, depending on the gene involved. There is more information on our Exeter website (www.diabetesgenes.org).
    For example, GCK mODY often needs no treatment, whereas patients with HNF1A MODY are very sensitive to certain tablets called sulphonylureas, but often need additional insulin in later life.

    I hope that helps to clarify.

    Best wishes,

    Rachel Besser
     
  5. madde

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    It does help! Thank you for the link!
     
  6. madde

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    So, in essence, everyone who was originally diagnosed with type 1 diabetes should be re-tested to see if they have a genetic form of diabetes? I wonder why this isn't standard testing now that so many more types of MODY have been discovered.
     
  7. kimmcannally

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    I think the standard of care is to only test for MODY if dx with T1 at under a year old. Obviously, that didn't apply to the woman in this story. Wonder if they will change that? I remember they did some testing at our dx and said DS was definitely T1, but everything was so crazy at the time, I didn't ask what type of test they did.
     
  8. TheFormerLantusFiend

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    If you are antibody negative at diagnosis, MODY testing might be a good idea. That's part of why they tend to test for antibodies. I have no reason to get tested for MODY because I was antibody positive at diagnosis (showing that I have Type 1a diabetes).

    The testing babies under a year is for a monogenic form of neonatal diabetes, which is not MODY.
     
  9. rebesser

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    Dear Jonah

    You are correct - Type 1 diabetes is implied if diabetes antibodies are positive. These antobodies are most likely to be detectable in Type 1 diabetes at diagnoiss, as they may go with time.In the past people were not tested for diabetes antibodies at diagnosis (in some places in the UK, they are still not).

    Another indication of MODY is to see if insulin secretion persists (which can be measured in a blood test or the new urine test - both measure c-peptide), beyond the normal time when you would expect insulin secretion to stop in Type 1 diabetes (usually 2-3 years, majority by 5 years).

    You are also correct about testing of neonatal diabetes in those diagnosed with diabetes under a year - although most likely to be tested positive for genetic types of neonatal diabetes if diagnosed in the first 6 months of life. This is not MODY, but neonatal diabetes.

    More information can be found here: www.diabetesgenes.org

    Best wishes,

    Rachel Besser
     
  10. madde

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    My daughter wasn't tested for antibodies at diagnosis. I just remember her endo. insisting she had type 1 diabetes based on her symptoms. If I had known better at the time, I would've insisted on it...
     
  11. rebesser

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    Many young people still stay positive for diabetes antibodies many years after diagnosis, depending on which ones get tested eg ICA tends to decline shortly after diagnosis, but GAD and IA2 may persist in around 80%. Worth talking to your endo about it.

    Best wishes,

    Rachel
     

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