Topiramate and type 2 diabetes: an old wine in a new bottle.
Topiramate, a marketed antiepileptic drug, has been used to treat seizures and allied neurological problems since 1999. Recently, a series of newer findings for the use of topiramate have cropped up, which include Type 2 diabetes and obesity. In a series of clinical studies, a subset of neurological patients with Type 2 diabetes mellitus (T2DM) serendipitously showed better glycaemic control when treated with topiramate. It has since been demonstrated that topiramate can act both as an insulin secretagogue and sensitiser in T2DM animal models. Pathogenesis of Type 2 diabetes involves both beta-cell dysfunction and insulin resistance. Therefore, an agent that has dual action (insulin secretagougue and sensitisation) is preferred for T2DM. Topiramate seems to act through multiple mechanisms to ameliorate diabetic symptoms, some of them unknown. Hence, it becomes imperative to discuss its probable modes of action. Topiramate raises new hope as an antidiabetic agent or a potential new chemotype with a better safety profile for the treatment of T2DM.
Khanna
Vivek
V
Ranbaxy Research Laboratories, Department of Pharmacology, New Drug Discovery Research, R&D III, Plot No. 20, Sector 18, Udyog Vihar Industrial Area, Gurgaon-122015, Haryana, India. vivek.khanna@ranbaxy.com
Arumugam
Surendar
S
Roy
Subhasis
S
Mittra
Shivani
S
Bansal
Vinay S
VS
D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005632:Fructose / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000737:chemistry / Q000627:therapeutic use*; D009765:Obesity / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D000077236:Topiramate
D007004:Hypoglycemic Agents; D000077236:Topiramate; D005632:Fructose