5th February 2024

This is a 36-year-old gentleman diagnosed with type 2 diabetes four years ago.

This is a 36-year-old gentleman diagnosed with type 2 diabetes four years ago. He presented with osmotic symptoms and a random blood sugar of 18mmol/L with no evidence of ketosis. Dietary advice and metformin monotherapy did not help, with his recent blood results shown below. He is on Atorvastatin. The patient had two brothers diagnosed with diabetes in their early twenties. 

Investigations:

Gliclazide 40mg was commenced, and two months later, there was a significant improvement in blood glucose reading, with HbA1c falling to 50mmol/mol and blood glucose readings in the range of 6-8 mmol/L, without significant hypoglycaemia. Genetic testing showed HNF1-alpha mutation.