Being a binge-watching Netflix enthusiast and having a poor diet, Brian suffers from type 2 diabetes, the most common form of the disease that affects some 30 million people in the United States. Despite his renewed efforts to initiate a lifestyle change by eating better and exercising more regularly, Brian’s blood sugar remains higher than normal. In addition, his insulin injections and pills are ineffective, increasing his concerns of developing heart disease, nerve damage, or other chronic ailments in the future.
As the prevalence of type 2 diabetes continues to grow, scientists are searching for new and effective ways of dealing with the disease. For one researcher in Texas, that means turning to a surprising source for a potential treatment, the venom from the desert predator lizard known as the Gila monster.
“Once, there were very limited options, none of which [were] very good,” says Curtis Triplitt, Pharm.D., an associate professor of medicine in the Division of Diabetes at University of Texas Health at San Antonio. He has focused his research career on the treatment and prevention of type 2 diabetes, a devotion inspired by his grandfather’s life as a diabetic.
“Now, there are exciting new medications that can offer substantial benefits to patients,” explains Triplitt.
The Gila monster is a large poisonous lizard native to North America. Due to a very slow metabolism, this lumbering, bulky reptile only eats three to ten times yearly. Incredibly, the Gila monster can consume up to one-third of its body mass while controlling its blood sugar levels for prolonged periods of time. In the mid-1990s, John Eng and Jean-Pierre Raufman, both researchers with the U.S. Department of Veterans Affairs, found that a hormone in the venom of the Gila monster could be used to stimulate the body’s insulin production. The hormone, exendin-4, is analogous to the human hormone GLP-1 that regulates blood glucose levels. A deficiency in GLP-1 in humans is a primary cause of type 2 diabetes and there are similarities in how exendin and GLP-1 work. As a result, researchers have followed Eng and Raufman in studying Gila monster venom as a potential treatment for the disease. One of those investigators is Curtis Triplitt.
Much of Triplett’s work focuses on the diabetes drug exenatide, a medication that resulted from the discovery of exedin-4. Exenatide can help those with type 2 diabetes by mimicking the effects of GLP-1. Exenatide improves the secretion of insulin by the pancreas, reduces glucagon levels that increase blood sugar levels and slows the emptying of the stomach. In April 2005, the U.S. Food and Drug Administration (FDA) approved Byetta, a synthetic form of exendin-4, for the treatment of diabetes.
Another research application for Gila monster venom is the development of combination drugs that act on more than one aspect of type 2 diabetes. These medications could potentially be more effective therapies.
Earlier this year, the FDA approved a combination drug, tirzepatide (Mounjaro), as a treatment for adults suffering from type 2 diabetes. What makes this drug unique is that it is the first in this new class of medications. Mounjaro is a dual GLP-1 and GIP agonist which acts with the central nervous system to provide feelings of fullness after a meal, making it likely to be more active against type 2 diabetes than traditional treatments. This injectable prescription medicine has proven to improve blood sugar control similar to exenatide. It also helps adults with weight loss and blood sugar control.
Initially, this new class of drugs looks promising but “there is still a long way to go to help more people benefit from this medicine,” Triplitt says.
Along with the inspiration provided by his grandfather’s diabetes, Triplitt says he’s encouraged to seek further understanding of the disease and how to better treat it by the connections he makes with patients who have type 2 diabetes.
“I have a valuable rapport with diabetics by improving their health education and personal care,” Triplitt says. “It is a rewarding experience that motivates me to find out how things work and then, hopefully apply that insight into new and improved treatments.”
The future of type 2 diabetes treatment has a positive outlook with some exciting prospects. A physician treating Brian, the patient mentioned previously, can now offer an enhanced treatment to promote blood sugar reduction and hopefully lower his cardiovascular risk. While merely speculation, science could be well on its way to a groundbreaking cure for diabetes. And surprisingly, such “monster” scientific advances may owe some of the credit to a prehistoric-remnant lizard out in the desert.
- As the prevalence of type 2 diabetes continues to grow, scientists are searching for new and effective ways of dealing with the disease.
- One Texas researcher is turning to a surprising source for a potential treatment, the venom from the desert predator lizard known as the Gila monster.
- Incredibly, the Gila monster can consume up to one-third of its body mass while controlling its blood sugar levels for prolonged periods of time.
Sources
Interview with Dr. Curtis Triplitt. Interview by Anthony Matejicka. July 21, 2022.
Garza, Matthew. “FDA Approves Mounjaro (Tirzepatide) for Diabetes Treatment.” DiaTribe, Last modified Sept. 1, 2022. https://diatribe.org/fda-approves-mounjaro-tirzepatide-diabetes-treatment.
Guyenet, Stephen J. “The Future of Weight Loss.” Works in Progress. Last modified Sept. 14, 2021 https://www.worksinprogress.co/issue/the-future-of-weight-loss/
Osterloff, Emily. “Gila Monster: Meet the Reptile Whose Bite Is Saving Lives.” Natural History Museum. https://www.nhm.ac.uk/discover/the-monster-whose-bite-saves-lives.html#:~:text=A%20breakthrough%20discovery%20found%20that,insulin%20production%20in%20the%20pancreas
Triplitt, Curtis, and Elaine Chiquette. “Exenatide: from the Gila Monster to the Pharmacy.” PubMed. Last modified Jan-Feb 2006. https://pubmed.ncbi.nlm.nih.gov/16529340/
“Type 2 Diabetes.” Centers for Disease Control and Prevention. Last modified Dec. 16, 2021. https://www.cdc.gov/diabetes/basics/type2.html#:~:text=More%20than%2037%20million%20Americans,adults%20are%20also%20developing%20it.
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Michael E. Newman is a seasoned science and medical communicator with 40-plus years of expertise in public affairs, journalism and broadcast media. He joined the Johns Hopkins Medicine media team as a senior media relations representative in March 2019. In this role, he communicates and promotes the research, clinical advances, service lines and related initiatives for a diverse group of the institute’s divisions. Michael came to Hopkins after 27 years at the federal government’s National Institute of Standards and Technology (NIST). At NIST, he served from 1991 to 2007 as director of media relations and then for the next 11 years as a senior communications officer.
Content Expert
Curtis Triplitt, PharmD., is an associate professor of medicine in the Division of Diabetes at University of Texas Health at San Antonio. He has focused his research career on the treatment and prevention of type 2 diabetes.
