The groundbreaking research has resulted in some astounding clinical breakthroughs. Led by Dr. Daniel Drucker, Senior Investigator at Mount Sinai Hospital’s Lunenfeld-Tanenbaum Research Institute, the team has discovered innovative classes of type 2 diabetes therapies that will change the landscape for diabetes sufferers struggling to manage their condition.

Scientific research, medical breakthroughs

Dr. Drucker’s research has predominantly been in the field of incretins, a class of gut-derived hormones that regulate the production of insulin and food ingestion. These incretin-based treatments developed in the Drucker Lab work in a glucose-dependent manner, which means they only lower blood sugar when it is elevated.

Unlike more traditional treatments, once the blood sugar is returned to a normal level, incretin therapies stop working to lower glucose, which drastically reduces the chances of hypoglycemia. “They also control your appetite, which is an added benefit of these therapies,” says Dr. Drucker. “People are able to control their glucose and, depending on the type of therapy they’re taking, can also get the benefit of weight loss.”

"These incretin therapies represent an entirely new class of agents with which to treat patients with type 2 diabetes. It’s a completely novel approach..."

Dr. Bernard Zinman, a Senior Scientist who has worked alongside Dr. Drucker at the Lunenfeld-Tanenbaum Research Institute, has been deeply involved in the testing of incretin therapies. He has conducted research studies aimed at discovering if incretin medications can improve the functionality of beta cells, which are responsible for producing insulin.

“Just recently we published a paper showing that the glucagon-like peptide receptor agonist [GLP-1] medication can maintain increased beta cell production of insulin,” says Dr. Zinman. “But once the drug is stopped, you go right back to base line.”

The new treatments

The breakthroughs in Dr. Drucker’s lab have contributed to the development of two new incretin hormone treatments for type 2 diabetes:  GLP-1 and dipeptidyl peptidase-4 inhibitors (DPP-4).

The GLP-1 agonists are molecules based on the structure of the naturally occurring GLP-1 hormone, which regulates the production of insulin in the body. The agonists activate a receptor, which leads to stimulation of insulin, inhibition of glucagon, delay in gastric emptying, and control of appetite. “These are four key elements for the control of blood glucose,” says Dr. Drucker. “GLP-1 agonists are injectable proteins that bind to the GLP-1 receptor.”

The DPP-4 inhibitor therapies work by blocking the activity of the DPP-4 enzyme, which is known to rapidly degrade the body’s GLP-1. “This treatment prevents the breakdown and extends the action of GLP-1,” says Dr. Drucker. “These medications are pills that patients can take once a day.”

Patricia Brubaker, Professor, Departments of Physiology and Medicine at the University of Toronto and Canada Research Chair in Vascular and Metabolic Biology, points out that “these incretin therapies represent an entirely new class of agents with which to treat patients with type 2 diabetes. It’s a completely novel approach,” says Professor Brubaker. “They have a relatively safe profile, in that they don’t cause hypoglycemia and, most notably, the GLP-1 receptor agonists also concurrently cause weight loss. The culmination of those three things makes these therapies unique.”

Collaborating towards success

Dr. Drucker’s 20 years of hard work haven’t gone unnoticed: he’s the proud recipient of the 2014 Banting Medal for Scientific Achievement Award from the American Diabetes Association, an award often described as the Nobel Prize for diabetes research. But rather than take the personal accolades, Dr. Drucker points to the doctors and scientists that he’s worked alongside and the continued support he’s received from within the medical funding community.

Most importantly though, away from the awards, is the impact that Dr. Drucker and his lab have made for Canadians with diabetes. “Patients now have a great ability to manage diabetes effectively while avoiding hypoglycemia and weight gain,” Dr. Drucker says, “those are fantastic benefits.”