What is the initial cause of insulin resistance?

Read this and comment. It may be that the lack of proper sleep may be causing insulin resistance and the epidemic of obesity and diabetes.

Drug helps brain control blood sugar in diabetics

LAURAN NEERGAARD

Associated Press

May 7, 2009

People with Type 2 diabetes may soon get a very different treatment approach: A drug that helps control blood sugar via the brain - an idea sparked, surprisingly, by the metabolism of migrating birds.

The U.S. Food and Drug Administration approved Cycloset, maker VeroScience announced yesterday. It’s a new version of an old drug called bromocriptine, which is used in higher doses to treat Parkinson’s disease and a few other conditions. But unlike its older parent, Cycloset is formulated to require a low, quick-acting dose taken just in the morning - no other time of day.

That timing provides a bump of activity in a brain chemical that seems to reset a body clock that in turn helps control metabolism in Type 2 diabetes, said VeroScience’s Anthony Cincotta, who led the drug’s development.

Company studies suggest that one morning dose helped lower the usual postmeal blood-sugar rise at breakfast, lunch and dinner. Over six months, 35 per cent of Cycloset users reached recommended average blood sugar levels, compared with 10 per cent of diabetics given a dummy drug.

Cycloset is the first drug to win FDA approval under new guidelines that require better evidence that diabetes treatments are heart-safe (diabetics are at increased risk of heart disease). In a year-long safety study involving 3,000 diabetics, those given Cycloset had 42 per cent fewer heart attacks and other cardiovascular complications than those given a dummy drug.

Where do the birds come in? Years ago, Louisiana State University researchers were studying how migrating birds arrived at their destinations without being emaciated. They develop seasonal insulin resistance, the very condition that in people leads to Type 2 diabetes.

People don’t have those seasonal variations, but the theory is that dopamine plays a role anyway in sensitivity to insulin.

The researchers discovered a biological clock - in the brain’s hypothalamus - that controlled when the metabolism change kicked in for the birds, and also in hibernating mammals. Different concentrations of certain brain chemicals, including dopamine, at different times of day dictated whether the bird metabolized like a fall bird or a summer bird, Mr. Cincotta said.

Bromocriptine mimics dopamine: “We’re regulating the regulator,” Mr. Cincotta said.

Side effects include nausea and dizziness, sometimes because of blood-pressure dips upon standing, and nursing women shouldn’t use it. Bromocriptine inhibits lactation, and although no link is proven, there have been reports of strokes in postpartum women using higher doses. The FDA said it also should be used cautiously with people on blood-pressure-lowering medication.

A company press released said now that it has the green light from the FDA, it will move forward with approval applications outside the United States, with an immediate focus on Europe and Canada.

Sleep is important but I am not sure about resistance. I know I now use a CPAP for sleep apnea, which was waking me a little about 20 times an hour. Now that it is under control my BG’s are better controled with less insulin. I think I just got the excuse I needed for a little extra sleep. Lack of sleep is related to weight gain. And there seems to be a strong link to T2, but they are just starting to study that.

Great that you managed to get the apnea under control.

I wonder how much the pharmos are going to charge for this low dose version of bromocriptine? It may be an older drug, but I’ll bet they find a new way to formulate it so that it can be licensed and priced obscenely high.

Dopamine also figures in depression…

There is no one “initial cause” of IR. It results from a myriad of causes ranging from defective mitochondria, to abnormal adrenal gland secretions, to pituitary function, to hormonal imbalances.

Bromocriptine has been around for a long time. Lyle Macdonald wrote a book about it. It isn’t a miracle cure.

Could be the Globe and mail needed a miracle cure article. Is the Lyle MacDonald book worth reading?

I agree with: “It may be that the lack of proper sleep may be causing insulin resistance and the epidemic of obesity and diabetes.” (My emphasis.)

I seem to loose weight when I take a nap after exercising, go to bed early, and sleep in on weekends regularly. Good night.

Dear Lucille.

Ever since about 1 or 2 years now my insomnia and weight gain seem to go in parallel. It could be a happen-change correlation but I think there is something to this.

Insomnia is awful. I’ve experienced it several times from too much caffeine (a few glasses of iced tea will give it to me) too late in the day. Also, once for a few days in a row from a post surgery pain medication on which I couldn’t even fall asleep to nap during the day after being up until 3AM before falling to sleep. So could your isomnia be medication related?

I am basically taking only the insulin. I find it very hard to fall asleep if the BG is not just right. Has to be around 90 then it can go a bit low to 70 and I will wake up . very hard to get just right.

Initial cause? My mother in law.

rick phillips

Marking this for later…