[acb-diabetics] new drug may help type 1 diabetics

[Patricia LaFrance-Wolf]

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UT Southwestern researchers, using mouse models, found that leptin
administered instead of insulin showed better management of blood-sugar
variability and

lipogenesis, the conversion of simple sugars into fatty acids. Leptin is a
hormone produced by fat cells and involved in the regulation of body weight.


 

Dr. Roger Unger, professor of internal medicine at UT Southwestern, writes
that insulin treatment has been the gold standard for Type 1 diabetes
(insulin-dependent

diabetes) in humans since its discovery in 1922. Dr. Unger's laboratory
found that insulin's benefit resulted from its suppression of glucagon, a
hormone

produced by the pancreas that raises blood sugar levels in healthy
individuals.  

 

"Insulin cells are destroyed in people with Type 1 diabetes, however, and
matching the high insulin levels needed to reach glucagon cells with insulin
injections

is possible only with amounts that are excessive for other tissues," said
Dr. Unger, senior author of the latest study. "Peripherally injected insulin

cannot accurately duplicate the normal process by which the body produces
and distributes insulin." 

 

People on insulin therapy tend to experience large swings in blood-sugar
levels, said Dr. Unger. Other studies have shown that frequent blood-sugar
variation

complicates the symptoms of Type 1 diabetes, which affects about 1 million
people in the U.S. 

 

Benefits of letpin's glucose-lowering action appear to involve the
suppression of glucagon. Normally, glucagon is released when the glucose
level in the

blood is low, thanks to supervision by insulin release from neighboring
cells. In insulin deficiency situations, however, glucagon levels are
inappropriately

high and cause the liver to release excessive amounts of glucose into the
bloodstream. This action is opposed by insulin, which tells the body's cells

to remove sugar from the bloodstream. 

 

"Leptin treatment in the non-obese Type 1 diabetic mouse profoundly reduced
food intake, which in turn reduced body fat," Dr. Unger said. "And like
insulin,

leptin suppresses glucagon in the body and helps increase lean body mass." 

 

As a countermeasure to the destruction of their pancreatic islet cells, Type
1 diabetics currently must take insulin multiple times a day to metabolize

blood sugar, regulate blood-sugar levels and prevent diabetic coma. They
also must adhere to strict dietary restrictions. 

 

"We hope the positive results we've had in animals can translate to people
living with this disease," Dr. Unger said. "Insulin therapy has transformed
a

uniformly fatal disease into a livable one; however, the regimen for people
with Type 1 diabetes is onerous and symptoms aren't always well controlled.

We hope that low-dose insulin combined with leptin will closely mimic the
body's normal physiological process."

 

Available online and in a future issue of the Proceedings of the National
Academy of Sciences. 

 

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