Incretins are hormones produced by the intestines that instruct the pancreas to make insulin when you eat. An enzyme called DPP-IV turns off incretin; DPP-IV inhibitors block the enzyme, which in theory should allow for greater insulin production. Early studies show that people with type 2 diabetes who take the drug experience impressive dips in blood sugar. Several companies are developing their own versions of the drug.
Another drug that could benefit people with diabetes and may become available by 2007 has a curious history. Scientists have long known that smoking marijuana makes people ravenously hungry for pizza, potato chips, cookies, and other high-calorie foods. (Yes, this phenomenon has actually been proven in lab studies, even though the same scientists could have amassed equally convincing evidence by walking into practically any college dorm in the country.)
Some buzz-kill researchers came up with an idea: Would turning off cell receptors in the brain that are stimulated by chemicals in marijuana eliminate "the munchies"? And if so, could doing so help people who battle the bulge control appetite?
A French pharmaceutical company developed a drug called rimonabant that does just that. A 2005 study found that overweight people who took rimonabant for a year sustained an average weight loss of 15 pounds, while a similar group of people who took empty placebo pills lost just 4 pounds.
This news alone should be of interest to people with type 2 diabetes who struggle with weight problems. However, rimonabant also seems to produce a modest but significant drop in blood sugar, beyond the glucose improvement that might be expected from simply losing weight.
The drug also raises HDL ("good") cholesterol and lowers unhealthy blood fats called triglycerides, which decrease the risk for heart disease. If the drug is approved by the FDA, some doctors who treat people with diabetes have already said they plan to prescribe it to patients with mildly elevated blood sugar.