Arthritis Drug Helps With Type 2 Diabetes
April 17, 2007 – 10:38 am | posted in Diabetes, EndocrinologyA European study has discovered that a drug normally used to treat rheumatoid arthritis may help people with type 2 diabetes.
The study was published in the New England Journal of Medicine (NEJM).
Scientists from Denmark, Sweden and Switzerland conducted a 13-week, double-blind, parallel-group trial on 70 patients with type 2 diabetes. 34 of them had daily injections of anakinra (marketed as Kineret) and 36 had a placebo.
Levels of blood sugar in the anakinra group went down slightly in the long term, while they went up in the placebo group.
After the 13-week period, the levels of glycated hemoglobin in the anakinra group were 0.46 percentage points lower than the placebo group.
Lead researcher, Dr Marc Donath, professor of endocrinology and diabetes at the University Hospital of Zurich, Switzerland said that the study was intended to prove the concept that it was possible to slow down the progress of the disease, and possibly its side-effects as well, such as arteriosclerosis.
So how does a drug to treat arthritis work for diabetes? The answer lies with a chemical messenger family called interleukin-1.
Anakinra is a manufactured version of a natural interleukin-1 antagonist that blocks the action of interleukin-1 and is normally used to treat arthritis.
Interleukin-1 is a family of naturally occurring compounds used to send signals between cells in the body, rather like hormones and neurotransmitters. Too much of it causes inflammation and increased wear and tear of cartilage that is associated with rheumatoid arthritis.
However, a particular type of interleukin-1 called Interleukin-1beta also destroys the beta cells in the pancreas that produce insulin. It is associated with high levels of blood sugar, a condition of diabetes.
So, the theory is, that by injecting anakinra, the type 2 diabetes patients were able to reduce the action of interleukin-1beta, slow down the destruction of pancreatic beta cells and therefore retain some insulin production capacity of their own.
Insulin production in the patients who injected placebo however, continued to deteriorate because their beta cells continued to die, along with their ability to produce insulin.
The researchers reported that levels of interleukin-1 also went down in the anakinra group, as did levels of C-reactive protein (CRP) a marker of inflammatatory processes being present in the body.
However, insulin resistance, insulin-regulated gene expression in skeletal muscle, serum adipokine levels (another insulin regulator), and the body-mass index were similar in the two groups.
The scientists said that none of the patients who used anakinra had serious side effects and neither did their blood sugar drop too low.
Recently, a Brazilian study showed that stem cell transplants in patients with diabetes type 1 may kick start the pancreas into producing insulin again by regenerating beta cells.
“Interleukin-1-Receptor Antagonist in Type 2 Diabetes Mellitus.”.
Claus M. Larsen, Mirjam Faulenbach, Allan Vaag, Aage Vølund, Jan A. Ehses, Burkhardt Seifert, Thomas Mandrup-Poulsen, and Marc Y. Donath.
NEJM Volume 356:1517-1526, April 12, 2007, Number 15
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