Q & A Library

Type 2 diabetes affects some 17 million Americans. It occurs when cells in the body don't respond to insulin to maintain normal levels of blood glucose. This problem, called insulin resistance, results from the loss of insulin receptors on cell membranes. It is frustrating when, despite your best efforts, you can't correct it, but you're not alone. An estimated 57 percent of diabetes patients have similar difficulties. As you may know, if blood glucose levels remain too high too long, you're more likely to develop such diabetes complications as kidney disease, blindness and heart disease. Some Type 2 diabetes patients end up having to take regular injections of insulin to control their sugar levels.

One potential treatment that may help those in your situation is a new drug related to a compound found in the venom of the Gila monster, a remarkable lizard native to my home state of Arizona. The Gila monster eats only four times a year. Excretions in its saliva prevent a surge in blood sugar levels after the creature's infrequent meals.

The new drug, exenatide, already has been tested in one human clinical trial and others are ongoing. Results from the first one showed that 44 percent of patients achieved acceptable blood glucose levels and that study participants also lost an average of 7.5 pounds. The most common side effect was nausea, which decreased with continued treatment.

Exenatide seems to work by stimulating the body's ability to produce insulin in response to elevated glucose levels, slow the rate of nutrient absorption in the bloodstream, and inhibit release of glucagon following meals. (Glucagon is the hormone that opposes the effect of insulin.) I'm told that the drug manufacturers Lilly & Co. and Amylin Pharmaceuticals plan to submit the results of their studies to the Food and Drug Administration in 2004.

Andrew Weil, M.D.