Some patients experience enhanced effects, while others need gentler titration to manage increased digestive symptoms
For patients with HNF1A - MODY, HNF4A - MODY, and ABCC8 - MODY, SUs stimulate insulin secretion by enhancing ATP-independent closure of the K ATP channels, and therefore, bypass the low level of ATP in the pancreatic cells or decreased sensitivity to ATP.37 Although the transcription factor Hnf1b has a very similar structure to the transcription factor Hnf1a and shares a DNA-binding site, mutations in HNF1B result in reduced cell function due to pancreatic hypoplasia and increased hepatic insulin resistance
Fagher, B., Thysell, H., Nilsson-Ehle, P., Monti, M., Olsson, L., Eriksson, M., Lindstedt, S., and Lindholm, T
The idea that you could harness this signaling machinery and point it at specific problems is scientifically compelling