The diagnosis and treatment of diabetes is not always straightforward, particularly with lesser-known forms of the disease, such as maturity-onset diabetes of the young (MODY). Treatment depends mainly on the variety of MODY with which a patient is diagnosed. These forms of diabetes require treatment plans tailored to suit the needs of the individual.

Like type 2 diabetes, certain forms of MODY can be controlled primarily through diet and exercise, at least in the early stages. Other forms of this disease may require antidiabetic agents or insulin administration. There are important distinctions among the eight known forms of MODY. Testing can help establish the appropriate treatment protocol.

The physician will establish a target glucose (blood sugar) range and a schedule of home glucose monitoring, other self-testing if needed (e.g., ketone tests), foot care and skin care. There will also be a schedule of medical appointments for physical examinations, complete foot exams, blood tests such as the glycohemoglobin test of glucose control and urine tests such as the microalbuminuria test of kidney function.

The physician can create a sick-day plan to help keep illnesses from disrupting metabolic control. Patients can be referred to a certified diabetes educator and registered dietitian for assistance in managing their condition. They should go to an ophthalmologist for regular eye exams and have regular dental care to reduce their increased risk of gum disease.

Patients needing antidiabetic agents may be prescribed sulfonylureas or other drug categories or combinations.

Choice for insulin-dependent MODY patients may include syringe injections, insulin pens or insulin pumps. In its approval of inhaled insulin in 2006, the U.S. Food and Drug Administration (FDA) specified adult nonsmokers with type 1 diabetes or type 2 diabetes, so it is not clear whether adults with MODY may qualify. An islet cell transplant may be an option for some MODY patients, although the procedure is still considered experimental.

As with other forms of diabetes, lifestyle changes (quitting smoking, good nutrition, physical activity) can delay or help control the disease.

There are no known ways to prevent the onset of MODY. If the disease has been inherited (and confirmed through genetic testing), the chances of developing MODY are nearly 100 percent.

Initially, physicians found little evidence of typical diabetic complications from MODY, particularly microvascular problems, including the kidney disease diabetic nephropathy and the eye disease diabetic retinopathy. However, it is now believed that certain forms of MODY can indeed lead to these complications, and physicians recommend controlling cholesterol and blood pressure as well as glucose.