Bromocriptine: A New Type of Type 2 Drug
As described by Health Central blogger Bill Quick, the FDA recently approved the drug bromocriptine mesylate for use in treating type 2 diabetes.
This is not a new drug; it's just a new use for an old drug. Bromocriptine (which is an ergot alkaloid), has been used for decades to treat diseases like Parkinson's, acromegaly, and high levels of prolactin. It acts on the dopamine receptors in the brain to produce the same effects as dopamine would produce.
So what does dopamine have to do with type 2 diabetes?
Most people who have never had a problem with overweight or obesity think that obesity is caused simply by eating too much and not exercising enough. I think in cases of mild overweight, for example, the college athlete who becomes accustomed to eating superlarge meals because of the superlarge exercise and then gets a desk job and doesn't adjust his food intake accordingly, or for the person who gets tired of cooking and eats nothing but nutrient-poor TV dinners and fast-food burgers and fries and puts on 10 or 15 pounds, this is probably true.
But for people who have had a lifelong battle with obesity, or people who have always been thin and active and then suddenly, often after menopause in women, start packing on the pounds without a significant change in eating or exercising habits, something else is obviously going on.
That something is likely hormones, and hormones can be triggered by the brain. Hence a drug that works on the brain might go to the root cause of some cases of obesity and type 2 diabetes rather than simply working on the symptoms of diabetes: high blood glucose (BG) levels.
The interesting thing is that animals that hibernate not only put on a lot of weight before they hibernate (so their energy reserves are larger; in a few cases, they do just the opposite and lose a lot of weight so their energy requirements are lower) but they also become insulin resistant. And bromocriptine can reverse this prehibernation pattern of weight gain and insulin resistance.
Hence there's a rationale for this drug, which attacks the problem of insulin resistance, type 2 diabetes, and obesity, in a new way. However, there are also side effects, as Quick described. Any new drug has promise, but it also has risks. Even commonly accepted drugs like aspirin and beer have side effects.
We often don't know until thousands of people have tried the drug whether the benefits of the drug outweigh the risks. We should keep informed, work with our doctors to decide on the best drug for our own particular situation, and then pay careful attention to the results.
If you'd like to know more about bromocriptine, hibernation, and theories of weight gain, see here.