Saliva-Derived Drug Helps Treat Diabetes

June 17, 2003 (New Orleans) -- A novel drug derived from the saliva of a poisonous lizard may help to treat people with type 2 diabetes even when all other medications fail, researchers say. The drug also seems to aid weight loss.

In a new study, the experimental drug, known as exenatide, helped regulate blood sugar levels in people who had "been trying to bring their diabetes under control for years," says Alain Baron, MD, senior vice president of clinical research at San Diego-based Amylin Pharmaceuticals Inc., which is co-developing the drug with Eli Lilly and Co.

Injections Treat Type 2 Diabetes

At the American Diabetes Association 63rd Scientific Sessions on Monday, Baron reported the results of studies of 63 people with type 2 diabetes whose blood sugar levels remained high despite standard medication. Injections of exenatide resulted in improved blood sugar levels and weight loss.

Some 17 million Americans suffer from diabetes, in which the body fails to make enough insulin or to process it properly, causing blood sugar levels to spike.

In the 63 patients who completed 20 weeks of treatment, hemoglobin A1C -- a standard measure of blood sugar levels -- dropped an average of 1.4 points to 7.2% -- close the American Diabetes Association's target level of 7.0% or below. And in more than half of the patients, hemoglobin A1C fell below 7.0%.

The most frequent side effect was mild to moderate nausea, which affected about 27% of participants. But Baron says that queasiness was not the reason for the patients' weight loss.

Several studies pitting exenatide against placebo are nearing completion, with the first results to be presented at an international diabetes conference in Paris in August, Baron says.

"The only other agent with this level of effectiveness in this population is insulin," he says. "And insulin is associated with weight gain and an increased risk of low blood sugar, or hypoglycemia.

"One the most unique aspects of exenatide is that it increases insulin secretion on demand -- only when blood sugar is high, but not when it is low," Baron says. "As a result, it does not increase the risk of hypoglycemia."

The drug represents the first of an entirely new class of agents -- dubbed the gut peptides -- that attack diabetes in a totally different way than medications now in use, he says.

Almost every major pharmaceutical agency in the field has one such drug in development. But exenatide is the furthest along.

Exenatide Stirs Excitement

Diabetes doctors who heard the results were enthused about the drug's potential to help patients with stubborn diabetes.

"Exenatide is one of the most exciting developments we've seen at this year's meeting," said Eugene Barrett, MD, PhD, the new president of the American Diabetes Association. "It comes at treating diabetes in a totally different direction. Exenatide acts specifically to increase insulin secretion to a degree unmatched by any drug on the market." Barrett is professor of internal medicine at the University of Virginia in Charlottesville.

The one drawback, he says, is the drug can only be taken as an injection.