Instead of trying to make the body more sensitive to insulin, is it possible to treat type 2 diabetes by slowing the production of glucose in the liver?
A new study, led by Washington University School of Medicine in St. Louis and published in the journal Cell Metabolism, suggests it is.
Working with mice, the team found that shutting down a liver protein that controls glucose production led to lower levels of blood sugar.
The finding could lead to more effective treatments for type 2 diabetes, says study leader Brian N. Finck, associate professor of medicine.
One drug that the researchers experimented with in their study may have such an effect – the investigational drug MSDC-0602.
According to the manufacturer, Metabolic Solutions Development Company of Kalamazoo, MI – who describe MSDC-0602 as an insulin sensitizer – the drug is currently undergoing trials as a treatment for type 2 diabetes.
Previous research had already suggested interfering with a mechanism that transports pyruvate – a building block of glucose – from the bloodstream into the mitochondria of liver cells may reduce glucose production in the liver. Mitochondria are tiny compartments inside cells that produce the energy they need.
Prof. Finck and colleagues took this discovery further and showed that inhibiting a protein called mitochondrial pyruvate carrier 2 (MPC2) in the liver of mice blocked pyruvate transport and cut glucose production.
The study is the first to show the critical role that MPC2 plays in glucose production in the liver.
The team believes that disrupting pyruvate transport may also help treat nonalcoholic fatty liver disease – a condition that is common in people who are obese.
For most people, nonalcoholic fatty liver disease causes no signs and symptoms and no complications. But in others, it can lead to inflammation and scarring of the liver, and in very severe cases, result in liver failure.
MSDC-0602 is also being developed to treat nonalcoholic fatty liver disease.
The Centers for Disease Control and Prevention (CDC) say diabetes is rising at an “alarming” rate in the US. A CDC report in 2014 puts the number of Americans affected by the disease at 29 million – 12% of adults. The vast majority of cases are type 2 diabetes.
Prof. Finck concludes:
“A drug that shuts down glucose production has the potential to help millions of people affected by the most common form of diabetes.”
Meanwhile, Medical News Today learned that a delayed release version of metformin, tested in a study recently published in the journal Diabetes Care, could suit the 40% of type 2 diabetes patients who cannot use the current formulation.
In that study, researchers show that the glucose-lowering effect of metformin takes place in the gut and not in the bloodstream as previously thought.