AsianScientist (Oct. 23, 2014) – Yohimbine, a drug currently used to treat male sexual dysfunction, could also be helpful for a certain subset of diabetic patients. A study published in Science Translational Medicine has shown that yohimbine can enhance insulin production in type 2 diabetic patients carrying a variation in the ADRA2A gene. This finding has implications for personalized diabetic therapy in the future, where patients receive treatment based on their genotype.
“The interesting aspect of this risk variant is that it is tied to a specific disease mechanism, rendering patients more sensitive to stress hormones (adrenaline) and thereby reducing insulin secretion,” said Dr. Anders Rosengren, of Lund University, Sweden, who was a co-author in the study.
Previous research has linked the ADRA2A genetic variant to abnormal insulin secretion in type 2 diabetes. In the present study, an international team of researchers led by Dr. Tang Yunzhao of Tianjin Medical University hypothesized that using yohimbine to inhibit the receptor in patients carrying the risk variant could also allow for unimpaired secretion of insulin.
Through a randomized, placebo-controlled study of 50 patients, the scientists studied the effect of varying doses of yohimbine on insulin secretion, as measured by an oral glucose tolerance test taken 30 minutes later, over three separate visits.
While patients with the risk variant initially presented with lower insulin levels than their counterparts without the variant, treatment with yohimbine was apparently able to remedy the difference.
“It is like driving a car with the brakes constantly on. If you add yohimbine, you release the brake and the car. That is, the insulin-producing cells can go at normal speed, secreting adequate amounts of insulin in response to glucose,” Dr. Rosengren explained to Asian Scientist Magazine.
The scientists hope that their finding can be used to shape the development of therapies which target the specific genotypes of type 2 diabetcs.
“This study shows that it may in fact be possible in the future to block the negative effect of risk variants and the findings open up a potential avenue to more personalized treatment using a combination of lifestyle modification and more specific drugs,” said Dr. Rosengren.
The article can be found at: Tang et al. (2014) Genotype-based treatment of type 2 diabetes with an a2A-adrenergic receptor antagonist.
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