Saturday, November 8, 2014

Verapamil can reverse Diabetes

Verapamil can increase the beta cell mass: Verapamil, a drug used to control high blood pressure and arrhythmias has been shown by Dr Anath Shalev at University of Birmingham, Alabama to not only prevent type 1 diabetes in mice but reverse severe established diabetes. The drug down regulates a key promoter of type 1 diabetes (thioredoxin-interacting protein ) and bolster whatever dysfunctional beta cells remain in the pancreas. The treatment definitely creates an environment where beta cells are allowed to survive.

And now one year human trial, entitled, "The repurposing of verapamil as a beta-cell survival therapy in type 1 diabetes," is expected to begin early in 2015 by the same group.

Over a decade ago, the UAB team was able to identify a protein called thioredoxin-interacting protein (TXNIP), which is dramatically increased in human islet cells in response to high glucose levels. The researchers hypothesized that TXNIP might be involved in beta-cell death associated with diabetes. 

  Even short-term postprandial glucose excursions, as seen in pre-diabetes, may lead to a gradual, cumulative increase in TXNIP expression before any onset of overt diabetes. Furthermore, insulin resistance or any increased demand on the beta cell may also lead to elevated beta-cell TXNIP levels.
The team showed that TXNIP does indeed induce beta-cell death by apoptosis: in mice models in which TXNIP had been genetically deleted, for example, the animals were completely protected against diabetes.

Reduction of intracellular calcium inhibits the transcription and expression of TXNIP, so by using the calcium-channel blocker Verapamil to do this, they were able to mimic the effects of genetically deleted TXNIP in mice and preserve the insulin-producing beta cells.

Even after the animals had developed full-blown diabetes with high blood sugar levels, when treated with Verapamil, blood sugars normalized, and this was due to the reappearance and normalization of insulin-producing beta cells. [Mol Endocrinol. 2014:28:1211-1220]

Note: In India use of Verapamil in diabetes will be an off label use and hence will require consent. However those with high blood pressure or with hear blockages can be shifted to Verapamil.'

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