Sweet Guts

November 29, 2014 by

Nov. 21, 2014

By Medical Discovery News

Sweet guts

Your tongue isn’t the only part your body that can taste sweetness. Three years ago, scientists discovered that our intestines and pancreas have receptors that can sense the sugars glucose and fructose. This could revolutionize treatment for diabetics, who must closely monitor their blood sugar levels. A drug called New-Met, made by Eleclyx Therapeutics in San Diego, that is now in phase II clinical trials is attempting to do just that by targeting those sugar receptors in the digestive system.

It appears these taste receptors are basically sensors for specific chemicals that can serve functions other than taste in other parts of the body, although we don’t know what all those functions are yet. We do know the function of the T1R2/T1R3 taste receptor found on some cells in the intestine. When they detect sugar molecules, these cells secrete hormones called incretins, which in turn stimulate insulin production in the pancreas.

This neatly explains a phenomenon that had mystified scientists for over 50 years: eating glucose triggers significantly more insulin than injecting it directly into the bloodstream. When intestinal cells with sweet receptors detect sugar, they trigger neighboring cells to make a glucose transporter that allows the sugar to be absorbed by the body. The faster sugar is absorbed, the more signals are sent to the pancreas, and the more insulin it releases. Signals are also sent to the brain to tell us we are satiated. Artificial sweeteners can trigger the same effect. Understanding these signals is critically important in the control of blood sugar levels.

Metformin is a drug commonly prescribed to those with type 2 diabetes. It regulates blood sugar levels by decreasing the amount of glucose produced by the liver. Metformin may also modulate multiple components of the incretin signaling system. In combination with insulin, it increases the use of glucose in peripheral tissues like muscles and the liver, especially after meals, reducing blood sugar levels even further. Metformin is usually taken orally, so that it dissolves in the stomach and travels through the bloodstream to the liver.

New-Met is a novel formulation of metformin that dissolves when exposed to the pH in the intestine rather than the stomach. There, it binds to those sweet receptors and activates the release of incretins that stimulate the release of insulin, thereby regulating blood sugar levels. This mimics the natural signaling process triggered by sugars and is fast and direct. This reduces the amount of drug required to be effective by 70 percent. Patients on New-Met had fewer gastrointestinal side effects than those taking the standard metformin, which is the primary reason diabetics choose not to take it.

The number of people with diabetes will soon climb to 592 million, so the demand for better medications to treat them will continue to climb as well.

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A Teaspoon of Agavin

September 13, 2014 by

Sept. 12, 2014

By Medical Discovery News

Agave plant

Next time you have a bitter pill to swallow, think about reaching for a spoonful of agavin instead of sugar to help the medicine go down. You might not know what agavin is yet, but you’ve probably noticed that a number of alternative natural sweeteners like Stevia have been added to grocery store shelves next to traditional sugar. These products sweeten foods but often do not add calories or raise blood sugar levels. Recent research suggests that a sweetener made from agave, the same plant used to make tequila, may lower blood sugar levels and help people maintain a healthy weight.

Agavin is a natural form of sugar, fructose, called fructan. With fructan, individual sugar molecules are linked together in long chains. The human body cannot use this form of fructose, so it is a nondigestible dietary fiber that does not contribute to blood sugar levels. But it can still add sweetness to foods and drinks. Alternatively, agave syrup or nectar, while made from the same plant, contains fructan that has been broken down into individual fructose molecules so it does affect caloric intake and blood sugar levels.

Studies of mice prone to diet-induced obesity and type 2 diabetes found that when they consumed agavin, they ate less and had lower blood glucose levels, increased insulin, and more glucagon-like peptide-1 (GLP-1). GLP-1 is a hormone that inhibits gastrointestinal motility, which causes people to eat less because they feel fuller. It also stimulates the production of insulin. GLP-1 appears to be a regulator of appetite and food intake, and so it is being evaluated as a therapy for type 2 diabetes.

Further testing showed that when agavin was added to the water supply of mice eating a normal diet, they ate less, lost weight, and had lower blood glucose levels compared with mice that consumed other sugars such as glucose, fructose, sucrose, agave syrup, and the artificial sweetener aspartame. While these results are encouraging, the studies need to be replicated and then done using humans for agavin’s effectiveness to be proven. The possible long-term consequences of its use must also be examined. So far, the only known down sides are that agavin is not yet widely available and that it is not as sweet as sucrose or artificial sweeteners.

Agavin would join other natural sweeteners that do not add calories or affect blood sugar such as stevia, which is currently found in a variety of products. The stevia plant is native to Paraguay, where its leaves have been used as a sweetener for over a century. Stevia has been the subject of biological and toxicological studies for more than 50 years and its safety is well-established. It stimulates the pancreas to secrete insulin, a benefit to diabetics, and does not alter the naturally-occurring, beneficial bacteria in the digestive tract.

Thanks to agavin and other natural sweeteners, people with diabetes (or anyone watching their caloric and sugar intake) now have more choices than ever for sweeteners and products made with them, so they can eat or drink without raising their blood sugar levels. Agavin: it’s not just for tequila anymore.

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