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Sulphonylurea Transfer

This approach would be appropriate for patients with a confirmed mutation in HNF1A or HNF4A who have not previously progressed from diet, to sulphonylureas to insulin and with no previous history of ketoacidosis. Often these patients have been on insulin from diagnosis, in such cases we advise checking that both GAD and IA2 pancreatic antibodies are negative prior to transfer. These tests can be performed by the Exeter laboratory on request (further details available here). Some evidence of non insulin dependent diabetes is also helpful (but not essential), for example: a C-peptide measurement indicating the patient is producing some insulin of their own or patient’s own report of missing insulin for approx 3 days with no problem. We are able to measure urinary c-peptide creatinine ratio (UCPCR) in Exeter. Post prandial urine samples should be collected into boric acid containers (35ml MSU pot, red top) and posted via your local laboratory to Clinical Chemistry, Area A2, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW (further details available here).


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