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Advice for people with diabetes and their families

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Finding an alternative to metformin

Project summary

Lots of people with type 2 diabetes take a drug called metformin, but it’s not suitable for everyone. Another type of drug, called salicylate, works in a similar way to metformin. Dr Graham Rena will unpick how salicylate works, to figure out if it could be used as an alternative to metformin. This could mean more people with type 2 diabetes will have access to medications to help manage their condition and lower their risk of complications.

Background to research

If you have type 2 diabetes, the first medication you’ll start taking will probably be metformin. It helps the insulin you produce to work better and can help to protect against heart disease.

But metformin can become less effective the longer you take it, it can cause side effects, and it can’t prescribed for people with diabetes who have kidney disease.

Another type of drug, called salicylate, works in a similar way to metformin and scientists think it could be a good alternative for people with type 2 diabetes who can’t take metformin. Salicylate is already used to treat other health problems, like pain and inflammation. It acts like a key that opens different ‘locks’ inside our body, but scientists don't know which ‘lock’ is the important one to lower blood sugar levels.  

Research aims

Dr Graham Rena wants to learn more about how salicylate works in order to understand if it could be used to treat people with type 2 diabetes.

His team have developed a way of studying the inner workings of drugs in mice. By investigating the different changes that salicylate triggers in turn, they hope to identity which is the most important in helping insulin to work better and lower blood sugar levels. 

They previously found that a protein called fructose bisphosphatase-1 (FBP1) is cmainly responsible for explaining why metformin helps to lower blood sugar levels. They now want to know whether FBP1 is important for salicylate's effects too.

The researchers will also study other effects of salicylate that aren’t shared with metformin, including possible benefits on muscle and the kidneys.

Potential benefit to people with diabetes

Knowing more about how salicylate works could help scientists understand exactly how the drug could benefit people with type 2 diabetes. This will be an important step towards clinical trials testing the drug and ultimately making it available the diabetes clinic.  

This could mean people with type 2 diabetes who don’t benefit from, or can’t take, metformin could access an alternative treatment, to help slow the progression of their diabetes and protect against complications.

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