New Discovery Could Help Type 2 Diabetes Drug-Tolerance in Patients

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By : Suvarna Sheth

A new discovery that may help millions of patients with type 2 diabetes tolerate their medications better was reported this week by researchers at the University of Pennsylvania and Syracuse University.

By modifying a key ingredient in a current diabetes drug, researchers have found a compound that was effective for hyperglycemia without the side effects of current drugs.

“Drug regimens often have long lists of side effects which negatively impact treatment,” says Dr. Bart De Jonghe of University of Pennsylvania School of Nursing, and one of the lead study authors in a press release.

“In type 2 diabetes, nausea and vomiting top that list. It’s the main reason people stop taking their diabetes medications, and diminishes quality of life for millions who do take them,” he adds.

The widely prescribed, GLP-1 based drugs cause nausea and vomiting in between 20-50% of patients. The team of researchers modified the active ingredient, called exendin-4 to see if it would be tolerated better in animal models.

By attaching each molecule of exendin-4 to vitamin B-12, they produced a compound that is less absorbed into regions of the brain that trigger nausea and vomiting.

Because testing in animal trials was challenging, since lab rats and mice are unable to vomit, they focussed on testing with the musk shrew, a mouse-like animal with a vomiting reflex similar to humans.

Modification of the drug made a striking difference:  Both versions of the drug showed equal benefits for controlling blood sugar, yet vomiting occurred in almost 90% of shrews dosed with ordinary exendin-4 and only 12% of shrews treated with the modified version.

“The vomiting results are striking and very encouraging,” says De Jonghe in the press release. “It’s rare to see such positive results with a new drug compared to the standard. It’s hard to not be optimistic when you observe a complete flip in the side effect prevalence in favor of vastly improved tolerance.”

The discovery could improve diabetes management by leading to a next generation of already approved medications that are better tolerated, reducing the number of people who stop using medication due to side effects.

De Jonghe and his team presented their findings this week at the annual meeting of the Society for the Study of Ingestive Behavior, a leading international research conference for experts on eating behavior.