Treatment for MODY depends on the form of MODY you have such as MODY 2, which can be usually managed with exercise and diet and rarely drug or insulin therapy is needed. As MODY is a life-long disease, lifelong commitment to the following treatments is needed to keep blood sugar in control:
- Lifestyle changes such as healthy eating, regular exercise etc.
- If needed, oral diabetes medication or insulin therapy.
Lifestyle changes in MODY: This is an important aspect in the management of MODY like type 2 diabetes. Lifestyle changes recommended to control blood sugar levels include:
- Maintain healthy body weight: aim to maintain your body mass index in the healthy range of 18.5 -24.9. If you are overweight or obese, try to lose weight.
- Eat healthy: eat a balanced and healthy diet, which includes whole grain food, food rich in fiber such as fruits, vegetables, whole grains etc. Avoid processed food, food with simple sugars and fatty food. Watch your portion size and calorie intake; more calories than required even if as proteins impairs the blood sugar control and increases body weight. Limit the intake of sweets and salt, alcoholic beverages etc. Your doctor or dietician can advise you more on dietary changes that may be needed.
- Be physically active: any moderate physical activity for 30 minutes on most days of the week is recommended. Regular physical activity can help you maintain blood sugar levels and body weight.
If lifestyle changes do not maintain your blood sugar in the target range, medications will be needed, but medications should not be used instead of lifestyle modifications. Use your medication along with lifestyle modifications.
Medications to treat MODY
Sulfonylureas: These drugs are usually given to patients with MODY, who need medications. Thesulfonylureas (such as glipizideand glyburide) are taken orally and stimulate the pancreas to secrete more insulin.
Insulin for MODY: Some patients with MODY 1 and 3 (approximately 30-40%) may need insulin eventually to control their blood sugar levels. Insulin is given as an injection if oral preparations of insulin are not available. Many different types of injectable insulin are available. These include:
- Rapid-acting insulin such as regular insulin, lispro, glulisine, and aspart insulin.
- Long-acting insulin such as Ultralente insulin (has large zinc insulin crystals in an acetate buffer) and insulin glargine (a newer type of insulin, which has no peak and causes relatively stable blood level lasting more than 24 hours).
- Intermediate acting insulin such as neutral protamine Hagedorn (NPH) insulin (this has a mixture of regular and protamine zinc insulin) and Lente insulin (a mixture of 30% Semilente insulin and 70% Ultralente insulin in an acetate buffer).
Your doctor will prescribe the dose and type of insulin (short and long acting) to be taken based on your blood sugar control. Insulin injections can be taken as a standard injection or in other ways such as insulin pen, insulin infuser, jet injectors, insulin auto injector or insulin pump.
Patients with MODY 5 (a rare type of MODY) may require several different treatments as other organs apart from pancreas may be affected.
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