Aug. 27, 2003 -- It lowers blood sugar. It seems
to cause weight loss. And now it's the hottest drug
in the diabetes pipeline.
It also happens to come from the venom of the Gila
It's called exenatide and it's been grabbing headlines
at recent meetings of diabetes specialists. The newest
report comes from the 18th International Diabetes
Federation Congress in Paris. In a phase 3 clinical
trial, exenatide is being used to treat 155 type 2
diabetes patients whose blood sugar remains high despite
treatment with standard diabetes drugs.
After 24 weeks' of treatment with exenatide injections,
44% of the patients had their HgA1C levels -- which
indicate the average amount of sugar in the blood
-- drop to near recommended levels. And they lost
weight, too: An average 7.5 pounds, report Kristin
Taylor, PhD, and colleagues at Amylin Pharmaceuticals
Inc. in San Diego, Calif.
"These results are important, because many patients
with type 2 diabetes do not meet treatment targets
-- and those that do have difficulty maintaining those
targets," says exenatide researcher Michael Nauck,
MD, head of the diabetes center at Bad Lauterberg,
Germany, in a news release. "The fact that many
of the patients who failed to meet targets on other
medications were successful in reaching target with
exenatide is very encouraging."
A major side effect is nausea, although this seems
to get better with continued treatment.
From Lizard Venom to Diabetes
Gila monsters are poisonous lizards. They don't have
fangs like vipers. Instead, they grab onto their prey
with vice-like jaws while their grooved teeth leak
The lizards live in the desert, and eat as few as
four times a year. Between meals, their hunger system
shuts down. A chemical called exendin-4 is found in
their venom. When ingested with saliva, it wakes up
the lizards' metabolic system.
Oddly, this reptile molecule works in humans, too.
It lowers blood sugar and promotes weight loss. And
by a separate mechanism, it protects insulin-producing
beta cells in the pancreas and stimulates the growth
of new beta cells. Beta cell death is a major factor
in progression of type 2 diabetes.
Amylin Pharmaceuticals Inc. and Eli Lilly and Company
in Indianapolis, Ind. are developing exenatide. Lilly
is a WebMD sponsor.
Alzheimer's Protection, Too?
A compound similar to exenatide has two unpronounceable
names: HSEGTFTSD and [Ser(2)]exendin(1-9). In animal
studies, this compound protected brain cells from
toxic injury by plugging into a brain molecule called
The report, by University of Auckland researcher
Matthew J. During, MD, and colleagues, appears in
the August 17 issue of Nature Medicine.
GLP-1R may therefore be a promising target for treatment
strategies directed towards degenerative brain and
thought disorders, During and colleagues conclude.