Novel Lipid-Lowering Drug Effective in Type 2 Diabetes

An experimental lipid-lowering medication called volanesorsen improved insulin sensitivity and glucose control in type 2 diabetes patients during a recent trial.

Researchers have long suspected that high triglycerides increase the risk of heart disease and potentially worsen diabetes; however, there has not been a powerful enough tool to prove this hypothesis. In a study published in Diabetes Care, researchers enrolled 15 adult patients with type 2 diabetes and hypertriglyceridemia, who had been taking the oral medication metformin for diabetes.

Participants were randomized to receive either volanesorsen or placebo. After 12 weeks, patients who took volanesorsen saw a 69% reduction in triglycerides and a 57% improvement in whole-body insulin sensitivity. Furthermore, several tests of glucose control that included hemoglobin A1c showed significant improvement.

From the study’s findings, researchers concluded that the reduction in triglycerides was strongly related to the improvement in hemoglobin A1c and insulin sensitivity.

“These results prove volanesorsen to be an effective treatment method for improving insulin sensitivity, but what’s most interesting, and perhaps more encouraging, is that this drug also significantly improved patients’ hemoglobin A1c levels,” said lead co-author, Richard Dunbar, MD. “In most cases, it takes many months of therapy to improve the hemoglobin A1c, so to move the needle so significantly in a fairly short time is very promising.

“Scientifically, these results provide important proof that profoundly lowering triglycerides improves insulin sensitivity. And clinically, the results go a step further and show that doing so improves the underlying metabolic problems enough to actually improve diabetes.”

To quantify the drug’s effects, researchers used a sophisticated test called the hyperinsulinemic-euglycemic clamp. The test is largely regarded as the gold standard in insulin sensitivity measurement, according to the study.

To measure insulin sensitivity, the test involved the infusion of insulin at fixed rates, and the infusion of glucose at a varying rate, to keep blood glucose constant so researchers could determine how well a patient responded to insulin.

“While we were able to determine the effectiveness of this medication in a very specific group of diabetic patients, it will be important to evaluate this drug in a broader diabetic population,” Dunbar said. “The next phase will be to determine clinical success in patients with type 2 diabetes on the whole range of diabetic medications or perhaps with less severe lipid problems. It will also be important to conduct longer studies, as glucose control may improve even further with longer exposures to the drugs.”