Endocrine Abstracts

Introduction: Maturity-onset diabetes of the young (MODY) represents 1 to 2% of all cases of diabetes. MODY-3 is the most prevalent subtype and is characterized by a high sensitivity to sulfonylurea (SU) therapy. To date, we have scarce evidence about the efficacy of other therapies in this population, namely GLP-1 receptor agonists (GLP-1ra).

Objective: Evaluate the metabolic impact of GLP-1ra use in MODY-3 patients.

Methods: Retrospective descriptive study including patients with genetically confirmed MODY-3 followed at the Endocrinology Department of a tertiary referral centre. Data were analysed using SPSS v.27. Results were considered significant if P < 0.05.

Results: From a total of 53 patients with genetically confirmed MODY diagnosis followed at our centre, we selected 16 patients with MODY-3 for the final analysis (30.2%). We divided the patients in two groups: patients treated with GLP-1ra - group 1 – (n = 9, 56%) and patients not treated with – group 2 (n = 7, 44%). 12 (75%) of the patients of the total sample were female, with a median age at diagnosis of 23 (Q1 19 – Q3 26.5) and 18 (Q1 18 – Q3 24) years and a median disease duration of 29 (Q1 12.5 – Q3 36.5) and 17 (Q1 14 – Q3 27) years, respectively for the group 1 and 2. Patients of the group 1 (vs patients of the group 2) presented more weight loss – -7 ([-10.5]-[-4.5]) vs 0 ([-3]-2) kg, P = 0.011 – and a higher C-peptide/serum glucose ratio - 1.1 (0.7-2.4) vs 0.4 (0.3-0.5) ng/ml:mg/dl, P = 0.006. We did not find statistically significant differences between the two groups regarding total daily dosage of SU and insulin, frequency of usage of other pharmacological classes (namely metformin and SGLT-2 inhibitors), HbA1c and prevalence of micro and macrovascular complications.

Conclusion: Patients treated with GLP-1ra (group 1) presented a significantly higher weight loss and evidence of preservation of residual endogenous pancreatic secretion of insulin, highlighting the potential benefit of this pharmacological class in patients with MODY-3 diabetes mellitus.