A new drug for type 2 diabetes started showing up in drugstores this week, according to manufacturer Santarus. The FDA-approved drug, called Cycloset, takes an distinctive — and not well understood — approach to reducing blood sugar levels. The pill apparently works by increasing dopamine activity in the hypothalamus, a part of the brain. Dopamine is a brain chemical that plays a big role in people’s behavior, mood, and ability to sleep. Scientists theorize that glucose intolerance and insulin resistance may in part result from abnormal activity of this chemical, and that upping dopamine activity may iron out these problems.That’s the theory, at least: the drug’s exact workings aren’t known. But it seems to do the trick.
Research showed that Cycloset reduced patients’ A1Cs by 0.6% to 0.9% compared with a placebo (when used with other oral diabetic medication). But what about day-to-day blood glucose readings? The news is good there, too. A morning dose of the drug was shown to significantly lower blood sugars after meals — or postprandial plasma glucose levels, in researchers’ parlance.
Ralph DeFronzo, MD, chief of the diabetes division in the University of Texas Health Sciences Center, said, “Cycloset represents a new treatment for adults with type 2 diabetes. Although the mechanism by which Cycloset improves glycemic control is unknown, it contains bromocriptine mesylate, which increases dopaminergic activity in the hypothalamus.. . [It] can be prescribed for adults who are inadequately controlled with diet/exercise, metformin, sulfonylureas, or thiazolidinediones.”
During a randomized yearlong study, the drug was not associated with increased risk of heart attacks or other cardiovascular problems. It’s not recommended for those with type 1 diabetes or suffering ketoacidosis. Another cautionary note: Scientists haven’t studied how it might work in conjunction with insulin.
Santarus, a specialty biopharmaceutical company, also markets Glumetza, an extended-release metformin tablet. It’s developing several other drugs, including treatments for active ulcerative colitis, travelers’ diarrhea, and rheumatoid arthritis.
Santarus web site