A treatment for type 2 diabetes that targets the disease mechanism itself and not just the symptoms

http://stm.sciencemag.org/content/6/257/257ra139


Abstract

The feasibility of exploiting genomic information for individualized treatment of polygenic diseases remains uncertain. A genetic variant in ADRA2A, which encodes the α2A-adrenergic receptor (α2AAR), was recently associated with type 2 diabetes. This variant causes receptor overexpression and impaired insulin secretion; thus, we hypothesized that blocking α2AAR pharmacologically could improve insulin secretion in patients with the risk genotype. A total of 50 type 2 diabetes patients were recruited on the basis of ADRA2A genotype for a randomized placebo-controlled intervention study with the α2AAR antagonist yohimbine. The patients received 0, 10, or 20 mg of yohimbine at three separate visits. The primary endpoint was insulin secretion at 30 min (Ins30) during an oral glucose tolerance test (OGTT). Patients with the risk variant had 25% lower Ins30 than those without risk genotype. After administration of 20 mg of yohimbine, Ins30 was enhanced by 29% in the risk group, making secretion similar to patients carrying the low-risk allele. The corrected insulin response and disposition index in individuals with the high-risk (but not low-risk) allele were improved by 59 ± 18% and 43 ± 14%, respectively. The beneficial effect of yohimbine was not a consequence of improved insulin sensitivity. In summary, the data show that the insulin secretion defect in patients carrying the ADRA2A risk genotype can be corrected by α2AAR antagonism. The findings show that knowledge of genetic risk variants can be used to guide therapeutic interventions that directly target the underlying pathophysiology and demonstrate the potential of individualized genotype-specific treatment of type 2 diabetes.

http://www.sciencedaily.com/releases/2014/10/141014085025.htm

The gene variant is common. 30 per cent of the population have it and it is even more frequent among patients with type 2 diabetes -- out of 400 000 people in Sweden who have type 2 diabetes, 40 per cent of patients are carriers.

"Yohimbin neutralised the effects of the risk gene. The carriers of the risk gene gained the same capacity to secrete insulin as those without the risk variant," observes Yunzhao Tang, principal author of the recently published article.

Very interesting find Yoly I checked out yohimbine and it may not be much use to many of us. Time after time I have read about a drug that may be of use to us diabetics but always disappointed as I learn more. For the time being at least low carb is the only method I know of controlling our BG numbers with no known side effects or risks. Some have no option and have to use drugs or insulin but less always seems to be the best option.

From Wiki here http://en.wikipedia.org/wiki/Yohimbine

Depending on dosage, yohimbine can either increase or decrease systemic blood pressure (through vasoconstriction or vasodilation, respectively); small amounts of yohimbine can increase blood pressure, while large amounts can dangerously lower blood pressure.[6]

The therapeutic index of yohimbine is quite low; the range between an effective dose and a dangerous dose is very narrow.[23] Perceptible effects begin under half a miligram. A typical dose for sexual dysfunction would be 15–30 mg, whereas 100 mg would be considered dangerous. Overdose may also precipitate panic-type reactions, heart attack, and possibly death. Some have experienced severe adverse effects under 5mg.[citation needed]

Hallucinations or paralysis may occur with doses greater than 40 mg.[24] Higher doses of oral yohimbine may create numerous side effects, such as rapid heart rate, overstimulation, anomalous blood pressure, cold sweating, and insomnia. In rare cases panic attacks, hallucinations, headaches, dizziness, and skin flushing have occured.[23]

Serious adverse effects of overdose may include seizures and renal failure. Yohimbine should not be consumed by anyone with liver, kidney, heart disease, or a psychological disorder.[23]

Is a concept study. Yohimbine is a supplement in many parts of the world, used mainly for impotence. There is no money in it what they hope is to find a drug they can patent hopefully with less side effects. That is a big percentage that can be impacted and help even before they develop diabetes. More research trying to get at the origin of the many conditions under the umbrella of diabetes is a good thing. Being able to correct genetic problems could help many get better control and avoid other complications that may be consequences of the mutations and not of the BG control like in mitochondrial diabetes.