New Research on Type 2 Diabetes

This month I’m going to review a study that was published recently in Cell. 

More than half a billion people worldwide are affected by type 2 diabetes, and yet researchers still do not know what's behind the condition's breakdown in insulin functionality.  

Researchers from Case Western Reserve University in the US have now pulled back the molecular curtain and figured out why insulin, the hormone that maintains stable blood sugar, often stops working at its full effect.  

The principal investigator, Jonathan Stamler, is widely acclaimed for the discovery of S-nitrosylation, which is the process that turns nitric oxide (NO) into a ubiquitous messenger molecule capable of sharing information between cells. It's like putting a stamp on a letter. Nitric oxide is produced in almost all cell types and tissues, and it plays a crucial role in the functioning of the nervous system, the immune system, and in blood vessel dilation. What's more, dysregulation of  S-nitrosylation is increasingly found to be associated with a number of health conditions, such as multiple sclerosis, Parkinson's disease, sickle cell disease, and asthma.  

Only recently, however, has nitrous oxide been linked to aspects of the body's metabolism. Stamler and his colleagues previously suspected that the role of nitrous oxide is overlooked in some types of diabetes, and now, they have the evidence to support their hypothesis.  

The team at Case Western Reserve has discovered a novel enzyme, called SCAN (SNO-CoA-assisted nitrosylase), that plays a role in S-nitrosylation. It helps attach nitrous oxide to its target proteins, such as the receptors on insulin. In humans and mice with resistance to insulin, SCAN activity appears to be heightened. In mouse models of diabetes, Stamler and his colleagues found that when SCAN was inhibited, the animals did not show the classic symptoms.  

Together, the findings suggest that type II diabetes may be driven by an overabundance of nitrous oxide attaching to proteins like insulin. Any enzymes, like SCAN, that work to attach nitrous oxide to its receptors could, therefore, be useful targets in future research. Stamler hopes that by blocking the SCAN enzyme, scientists may find new treatments for at least some types of diabetes. Type I diabetes, however, is caused by a sheer lack of insulin production, and this would require a different avenue of treatment. 

I think it’s fascinating to see how the understanding of diabetes, particularly type 2 diabetes, is evolving. 

The discovery of the role of nitric oxide (NO) and the enzyme SCAN (SNO-CoA-assisted nitrosylase) in S-nitrosylation, and their potential link to insulin resistance, is indeed a significant breakthrough. This could open up new avenues for the treatment of type 2 diabetes, which affects a sizable portion of the global population. 

It is also intriguing to see how this research ties into the broader understanding of nitric oxide’s role in various bodily functions and diseases. The potential implications of this research could extend beyond diabetes to other conditions associated with dysregulation of S-nitrosylation, such as multiple sclerosis, Parkinson’s disease, sickle cell disease, and asthma. 

However, as the article mentioned, type 1 diabetes, which is caused by a lack of insulin production, would require a different treatment approach. It is a reminder of how complex and varied these conditions can be, and the importance of continued research in these areas. 

It’s always exciting to learn about new developments in medical research. That is why we at Palmetto Endocrinology always keep up with the latest developments to give our patients the best care possible.  And, as always, if you need an appointment, please call us. 

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.