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Towards a New Drug Class in the Treatment of Type 2 Diabetes

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Towards a New Drug Class in the Treatment of Type 2 Diabetes 

Type 2 diabetes is a major public health problem that affects millions of people worldwide. Developing new drugs to help better treat its underlying causes is therefore a research priority.

In a new study coordinated by Inserm researcher Vincent Marion in collaboration with Monash University, the University of Birmingham (UK), and Alexander Fleming, former senior endocrinologist at the US Food and Drug Administration (FDA), the scientists have developed PATAS, a peptide that is part of a new class of antidiabetic drugs. PATAS can correct the metabolic abnormalities leading to type 2 diabetes and its associated comorbidities which include insulin resistance(1).

PATAS works by specifically targeting the adipocytes (fat cells) (2), restoring glucose entry and thus correcting and re-establishing the metabolic physiology of the adipose tissue. The teams hope to set up a clinical trial soon to test this new therapy. Their study has been published in the journal Diabetes.

Diabetes mellitus is a chronic condition that affects 537 million people worldwide, with the majority affected by type 2 diabetes. The prevalence of type 2 diabetes, which is characterized by high levels of glucose in the blood (see box), has been increasing for decades due to population aging, inactivity, and poor diet. The age of onset is also decreasing, and although the disease is considered to be an “adult disease”, it is now seen frequently in adolescents and children.

Available drugs treat the consequences of type 2 diabetes by focusing mainly on lowering blood glucose; they do not target the underlying biological mechanism that causes the disease. Despite the urgency for developing new and more effective treatments, there have been no disruptive therapeutic innovations to reach market in over a decade.

And this is precisely the objective of the research led by Inserm researcher Vincent Marion and his team at the Medical Genetics Laboratory (Inserm/Université de Strasbourg). In a recent study in collaboration with the University of Birmingham and Monash University, the scientists have developed a product called PATAS in a new class of diabetes drugs called “Adipeutics” (for therapies that specifically target the adipocytes).

Their study, conducted on animal models, shows that this new therapy specifically restores glucose uptake in the adipocytes, resulting in the treatment of insulin resistance with beneficial effects on the whole body. This is made all the more promising by the fact that treating insulin resistance has the potential to address not only type 2 diabetes but a large array of serious medical conditions that result from this resistance.

 

Type 2 diabetes in brief 

Diabetes mellitus is characterized by excessive blood glucose levels over a prolonged period of time: this is known as hyperglycemia.

Hyperglycemia is caused by a reduced sensitivity of the cells, particularly those in the liver, muscle, and adipose tissue, to insulin. This is known as “insulin resistance.”

Insulin is a hormone produced by the pancreas whose role is to facilitate the entry of glucose into the body cells as their main source of energy.  To meet the increased demand for insulin caused by the cells’ resistance to this hormone, the pancreas produces even more insulin, depleting the body requirements. Insulin production then becomes insufficient and the blood glucose levels rise as a result.

The role of adipocytes 

This study follows on from years of rigorous, in depth work carried out in the lab. In previous research, published in Diabetes in 2020, the scientists had identified a new therapeutic target for type 2 diabetes when investigating at an ultra-rare monogenic disease known as Alström syndrome.

The scientists had shown that adipose tissue abnormalities (3) caused by a dysfunctional protein called ALMS1 led to extremely severe insulin resistance associated with early-onset type 2 diabetes in people with Alström syndrome. In animal models, restoring the function of this protein within the adipocytes re-established blood glucose balance.

The teams then went on to focus more closely on ALMS1 and how it interacts with other proteins within the adipocytes. In particular, they have shown that in the absence of insulin, ALMS1 binds to another protein called PKC alpha. The activation of insulin in the adipocytes induces the separation of these two proteins ALMS1 and PKC alpha, resulting in glucose entry into cells. In people with diabetes, who are insulin-resistant, this link between the two proteins is maintained.

Drawing on this knowledge, the scientists have developed the peptide PATAS, which works by breaking the interaction between ALMS1 and PKC alpha – thus restoring insulin signaling in the adipocytes.

In mouse models of diabetes, PATAS has been able to re-establish the normal physiology of the adipocytes by restoring glucose uptake. “Thanks to PATAS, the adipocytes that could no longer access glucose were once again able to absorb it and then metabolize it in order to synthesize and secrete lipids which are beneficial to the entire body. These positive effects are visible in our animal models, with a marked improvement in insulin resistance. Other parameters and comorbidities are also improved, including better blood glucose control and decreased liver fibrosis and steatosis,” explains Vincent Marion.

These promising results in animals have paved the way for the researchers to organise a clinical trial as soon as possible, in order to test PATAS in humans. The successful development of a new class of antidiabetic drugs could have significant implications for public health, not only to treat type 2 diabetes but also many other cardio-metabolic disorders in which dysfunctional adipocytes and insulin resistance are very problematic.

In order to create value from these findings and facilitate the organization of such a trial, Vincent Marion has founded the start-up AdipoPharma SAS.

 

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Vape Laws Spark Opposition

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Vape Laws Spark Opposition

 

Queuing at local pharmacies is expected to become longer and more complex due to new laws permitting pharmacies to sell e-cigarettes, commonly known as vapes.

As of 1 July, pharmacies are the sole legal dispensers of nicotine-containing vapes. Initially, customers will need a prescription to purchase these products, but starting 1 October, adults will be able to buy them after a consultation with the pharmacist.

However, the new legislation has sparked significant opposition from many pharmacy chains and independent chemists. The Pharmacy Guild of Australia has strongly criticised the move, describing the expectation for pharmacists to retail vapes as “insulting.”

“Pharmacists are healthcare professionals, and community pharmacies do not want to supply this potentially harmful, highly addictive product without a prescription,” stated Anthony Tassone, the guild’s national vice-president. Tassone also emphasised that vaping products have not been approved by the Therapeutic Goods Administration (TGA) and no nicotine-containing vape is listed on the Australian Register of Therapeutic Goods.

The controversial laws were passed by Parliament following a compromise between Labor and the Greens. Beginning 1 October, pharmacists who opt to sell vapes will be able to provide them to customers aged 18 or over with proper ID but without requiring a prescription, as nicotine vapes will be reclassified from schedule 4 to schedule 3 of the poison’s standard. However, individuals under 18 will still need a prescription to purchase nicotine vapes.

The intent behind the new laws is to regulate the sale of nicotine vapes more strictly while making them accessible for adults who choose to use them. Despite this, the Pharmacy Guild remains critical, highlighting the health risks associated with vaping and the added responsibility placed on pharmacists to manage these products safely.

As the implementation date approaches, the debate within the healthcare community and among the public is likely to intensify, raising questions about the balance between accessibility and safety in the regulation of nicotine vapes.

 

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Onsite Pharmacists – Just What the Doctor Ordered

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Onsite Pharmacists – Just What the Doctor Ordered

 

The Aged Care Onsite Pharmacist (ACOP) program aims to revolutionise medication delivery in residential facilities by placing trained professionals directly on-site.

Addressing Medication Mismanagement

The mismanagement of medications, inconsistent safety procedures, and low vaccination rates in aged care homes have long been controversial. Health authorities are urging providers to increase vaccine rates, as the lives of residents and communities are at risk. Despite these pleas, the Royal Australian College of General Practitioners reported that 97 aged care facilities had COVID-19 vaccination rates below 10%. Additionally, 706 facilities reported less than 50% of their residents vaccinated against COVID, with the lowest coverage in various states including New South Wales, Queensland, South Australia, Tasmania, Victoria, and Western Australia.

The Role of Onsite Pharmacists

The Aged Care Royal Commission identified medication delivery as a crucial area for improvement in aged care homes, recommending the employment of allied health practitioners, including pharmacists. Responding to this, the Federal Government has allocated $333.7 million to fund the ACOP program. This initiative enables residential aged care providers to engage pharmacists through local pharmacies or direct employment. These pharmacists will deliver personalised medications, manage frequent medication reviews, and administer antipsychotic drugs and vaccinations.

Goals of the ACOP Program

The ACOP aims to:

  • Improve medication use and safety in aged care homes, particularly the use of high-risk medications.
  • Ensure continuity in medication management through regular reviews and prompt issue resolution.
  • Provide easy access to pharmaceutical advice for residents and staff.
  • Integrate on-site pharmacists with the healthcare team, including local GPs, nurses, and community pharmacies.
  • Enhance understanding and response to individual resident needs.

Support from the Pharmacy Guild of Australia

The initiative has garnered support from the Pharmacy Guild of Australia, recognising the potential to elevate the role of pharmacies. This program enables pharmacists not only to deliver medications and dose administration aids but also to provide quality use of medicines within the facility. A Pharmacy Guild spokesperson highlighted the additional services pharmacists can offer, such as vaccinations, as they begin to practice to their full scope. This will create further opportunities for community pharmacies to become significant providers of healthcare services to aged care facilities.

Funding Model

The ACOP funding model is divided into two tiers:

  • Tier 1: Community pharmacies receive payments to engage with specific residential aged care facilities.
  • Tier 2: Residential aged care facilities can claim up to $138,282 per year for the full-time equivalent employment of an on-site pharmacist.

This government-funded initiative promises to improve medication management and overall healthcare in aged care facilities, ensuring better health outcomes for residents.

 

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Foods That Can Help Reduce or Prevent Joint Pain

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Minimally processed, whole foods That Can Help Reduce or Prevent Joint Pain
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Foods That Can Help Reduce or Prevent Joint Pain

 

Minimally processed, whole foods — including brightly coloured fruits and vegetables, healthy fats, and lean proteins — may help relieve inflammation and other symptoms that lead to joint pain. Inflammation is a common cause of joint pain, often associated with arthritis and other joint conditions. Eating foods that help reduce inflammation may improve joint pain and offer additional health benefits, such as improved heart health.

Can Diet Help Reduce Joint Pain?

Research indicates that diet can significantly impact joint health. A survey of 217 people with rheumatoid arthritis (RA) found that 24% reported their diet affected their symptoms. A 2023 study on osteoarthritis supports the idea that certain diet patterns can improve joint symptoms. Diets high in nuts, legumes, fruits, vegetables, and seafood, which contain anti-inflammatory properties like antioxidants and phytochemicals, may help reduce joint pain.

Beneficial Foods for Joint Pain

Incorporating anti-inflammatory foods into your diet can help reduce joint pain and slow disease activity. Beneficial foods include:

  • Nuts: Rich in healthy fats and antioxidants.
  • Legumes: High in fibre and protein, reducing inflammation.
  • Fruits and Vegetables: Packed with vitamins, minerals, and antioxidants.
  • Seafood: Especially fatty fish like salmon and mackerel, high in omega-3 fatty acids.

Foods to Avoid

To manage joint pain, limit or avoid processed foods, trans fats, and added sugars. A nutrient-rich diet can also help maintain a moderate weight, reducing strain on the joints.

Popular Diets for Joint Pain

The Mediterranean Diet

Emphasises fruits, vegetables, whole grains, legumes, and healthy fats, with moderate seafood and poultry, and limited dairy and red meat. Associated with reduced inflammation and improved joint health.

The DASH Diet

Includes fruits, vegetables, fish, poultry, nuts, whole grains, and low-fat dairy while restricting salt, sugar, fats, and red meat. May help improve and reduce the risk of gout, a type of arthritis that causes joint pain.

Conclusion

Incorporating a variety of nutrient-rich, anti-inflammatory foods into your diet can help manage and prevent joint pain. Following dietary patterns like the Mediterranean or DASH diets may offer comprehensive benefits for joint health and overall well-being.

 

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