Millions could benefit from discovery

A study led by University of Melbourne researchers has identified a protein that could revolutionise the treatment of a health problem affecting millions worldwide.

The newly discovered SMOC1 protein, produced by the liver, helps to control blood sugar levels, and could potentially be used to treat people with type 2 diabetes. Type 2 diabetes affects more than 400 million people worldwide and one million Australians. It causes high blood glucose levels, which can lead to cardiovascular disease and nerve and kidney damage.

Researchers Dr Magdalene Montgomery and Professor Matthew Watt told The Conversation that if the protein works in humans, as it does in mice, it could be injected once a week, rather than given daily as occurs with many current diabetes medications.

“Our results in mice suggest SMOC1 is more effective than metformin, the current frontline drug for type 2 diabetes, in improving blood glucose control and insulin sensitivity. It’s also without the risk of dangerously low blood sugar associated with current drugs,” they wrote.

“Any therapy that can effectively reduce blood glucose levels can have an enormous impact on patients,” Dr Montgomery said.

“It lowers their risk of developing diseases such as cardiovascular disease, chronic kidney disease, damage to blood vessels, which causes blindness, the risk of amputations and nerve damage, which causes pain.

“It was more effective at improving blood glucose control than the current frontline medication called metformin. It also reduces fatty liver and blood cholesterol levels, which are common health problems in type 2 diabetes patients.”

Metformin, currently prescribed to more than 120 million people globally, is safe, but it “frequently causes gastrointestinal symptoms such as diarrhoea and flatulence”.

The researchers say all diabetes medications have either “limited effectiveness or unpleasant side-effects”.

“Many can also potentially cause very low blood sugar (hypoglycaemia), which can cause shakiness, anxiety, sweating, chills, light-headedness, confusion and, in severe cases, coma or even death.”

A safer, easier to administer treatment could drastically improve the quality of life of many people.

SMOC1 is now ready to be tested in humans and, with the help of the pharmaceutical industry, trials could begin within six to eight years.

“Given the number of people with diabetes, the impact on reducing the burden on the healthcare system could be enormous, including less hospital visits, and shorter hospital stays,” said Prof. Watt.

“We have also shown that SMOC1 improves glucose metabolism in human liver cells, so we are certainly optimistic that SMOC1 will be effective in humans.” 

Prof. Watt advocates a healthy lifestyle but says diet and lifestyle have limited effectiveness as a treatment for type 2 diabetes. He said there are problems with current medications.  

“There are several medications that can be used alone or, increasingly, in combination that help maintain blood glucose levels in patients,” Prof. Watt said. “However, all type 2 diabetes medications, without exception, have either limited effectiveness or off-target effects that adversely affect the patient’s health. We need to develop new approaches.” 

He is seeking the support of the pharmaceutical industry.

“The injectable could move to human trials relatively quickly with the right support,” Prof. Watt said.

The Royal Australian College of General Practitioners (RACGP) says 280 Australians are diagnosed with diabetes every day.

Dr Gary Deed, chair of the RACGP Specific Interests Diabetes Network, is concerned that people with diabetes may be delaying or avoiding regular care during the COVID-19 pandemic. Diabetes appears to be associated with poor prognosis in those with the COVID-19 infection, according to The Lancet.

“A survey done in England showed that of 23,804 patients with COVID-19 dying in hospital, 32 per cent had type 2 diabetes and 1.5 per cent had type 1 diabetes, with 2.03 and 3.5 times the odds of dying compared with patients without diabetes, respectively.”

The RACGP believes SMOC1 is more effective than current treatments at “improving blood glucose control and reducing fatty liver and blood cholesterol levels”.

“This study is an early but important step to exploring options to manage type 2 diabetes, as emerging numbers are such a burden to healthcare worldwide,” Dr Deed told newsGP.

“Australian research such as this needs ongoing support as the quality of research here is world leading.”

Do you take medication for type 2 diabetes? Does this discovery offer you fresh hope of an easier way to control the disease?

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