Tackling Obesity and Type 2 Diabetes With Personalized Prescriptions

Canadian and German researchers are teaming up to identify new drug combinations to treat people with obesity and Type 2 diabetes.

The goal is to develop personalized prescriptions that are more effective than single drugs and that can potentially replace more invasive treatments such as bariatric surgery, especially for children.

“As a pediatric endocrinologist, I can tell you we’re seeing more and more Type 2 diabetes in kids and adolescents, and it seems to be a more aggressive form than adult-onset diabetes, so we do need better therapies to achieve even greater efficacy and degree of weight loss,” says Andrea Haqq, who is also a professor in the Faculty of Medicine & Dentistry and adjunct professor in the Faculty of Agricultural, Life & Environmental Sciences.

The researchers recently published a paper that examines the potential of several drugs that control incretins. These metabolic hormones stimulate the body to produce insulin and use it effectively. They also suppress appetite to control blood sugars and reduce weight.

The researchers conclude that combining the drugs has several advantages, including higher effectiveness in at least some patients and fewer side-effects.

“Our group is really focused on synergistic combinations of therapies for obesity and Type 2 diabetes, which are frequent comorbid conditions,” says Haqq.

Even a five per cent weight loss is considered clinically meaningful, and patients in some of the combination drug trials are achieving 10 or 15 per cent, says Haqq, who is a member of the Alberta Diabetes Institute and the Women and Children’s Health Research Institute. 

Taking research from bench to bedside

Haqq’s laboratory is collaborating with that of Timo Müller, director of the Institute for Diabetes and Obesity at the Helmholtz Diabetes Center and a researcher with the German Center for Diabetes Research in Münich, Germany.

“Dr. Müller is a basic scientist focused on in vitro or animal models of disease, and I’m a clinician scientist who sees many patients with obesity and diabetes, and works with clinical trials,” Haqq says. “So this collaboration allows us to bridge translational medicine and offer a unique perspective on precision therapy.”

As part of the collaboration with the Müller team, first author Qiming Tan, a PhD candidate in the Faculty of Medicine & Dentistry, will study for a term in Germany and a German student will join Haqq’s lab at the U of A.

Haqq and Tan recommend further research to identify why some individuals respond differently to the drugs. Some racial and ethnic groups bear a disproportionate burden of obesity and Type 2 diabetes, they say, so more participants from these groups are needed in trials. Further studies should also focus on how differences in biological sex affect drug efficacy and safety.

In addition to drug combinations, the researchers are looking for non-pharmacological solutions, such as how adding fibre to a person’s diet can slow weight gain and improve the effectiveness of existing diabetes medications.

The research was funded by the Alberta Diabetes Institute, the International Helmholtz Research School for Diabetes and the Weston Family Foundation. Haqq has been part of unrelated clinical trials for Rhythm Pharmaceuticals and Levo Therapeutics. 

Reference: Tan Q, Akindehin SE, Orsso CE, et al. Recent advances in incretin-based pharmacotherapies for the treatment of obesity and diabetes. Front Endocrinol. 2022;13. Doi: 10.3389/fendo.2022.838410

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