GLP-1 RA and dual GIP/GLP-1 RA treatment in MODY: a descriptive case series

BMJ Open Diabetes Res Care. 2025 Apr 23;13(2):e004885. doi: 10.1136/bmjdrc-2024-004885.

Abstract

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dual glucose insulinotropic polypeptide (GIP)/GLP-1 RA are widely prescribed, but their effectiveness in different subtypes of maturity-onset diabetes of the young (MODY) is unknown.

Research design and methods: We present a descriptive case series of individuals from two MODY cohorts who used GLP-1 RA or dual GIP/GLP-1 RA. Paired t tests were used to compare HbA1c, body mass index (BMI), and sulfonylurea (SU) dose before and after GLP-1 RA or dual GIP/GLP-1 RA therapy.

Results: 10 individuals (4 hepatocyte nuclear factor-1α (HNF1A)-MODY, 4 hepatocyte nuclear factor-4α (HNF4A)-MODY, 1 ATP-binding cassette transporter subfamily C member 8 (ABCC8)-MODY, 1 hepatocyte nuclear factor-1β (HNF1B)-MODY) were identified who used GLP-1 RA or dual GIP/GLP-1 RA. In patients with HNF1A-MODY and HNF4A-MODY, GLP-1 RA reduced HbA1c by 1.3% (p=0.010), BMI by 2.90 kg/m2 (p=0.008), and total daily dose of SU by 66.6% (p=0.005). Dual GIP/GLP-1 RA treatment led to a non-statistically significant decrease in HbA1c of 1.8% (p=0.104), a statistically significant reduction in BMI of 8.73 kg/m2 (p=0.010), and all patients discontinued SU (n=2) and one discontinued insulin. In patients with ABCC8-MODY and HNF1B-MODY, GLP-1 RA reduced HbA1c by 1.2% and 1.8%, BMI by 1.1 kg/m2 and 1.2 kg/m2, and the patients no longer required treatment with SU or insulin, respectively.

Conclusions: GLP-1 RA and dual GIP/GLP-1 RA lowered HbA1c, BMI, and SU dose in patients with MODY.

Keywords: Diabetes Mellitus, Experimental; Genetics; Glucagon-Like Peptide 1; Glycated Hemoglobin A.

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Blood Glucose / analysis
  • Body Mass Index
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / pathology
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Gastric Inhibitory Polypeptide* / therapeutic use
  • Glucagon-Like Peptide 1
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Male
  • Middle Aged
  • Prognosis
  • Sulfonylurea Compounds / therapeutic use

Substances

  • Gastric Inhibitory Polypeptide
  • Hypoglycemic Agents
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Glycated Hemoglobin
  • Blood Glucose
  • hemoglobin A1c protein, human
  • Sulfonylurea Compounds
  • Biomarkers
  • Glucagon-Like Peptide 1

Supplementary concepts

  • Mason-Type Diabetes