Diabetes pill burns fat without muscle loss, study suggests
A new diabetes pill that burns fat and controls blood sugar differently to GLP-1 drugs such as Ozempic has shown early promise in trials.
While injectable GLP-1 medicines suppress appetite (they mimic a gut hormone that helps control hunger and insulin), the experimental treatment is claimed to boost muscle metabolism, potentially avoiding the muscle loss seen with current weight-loss drugs.
An early animal study and a human trial involving 48 healthy adults and 25 people with type 2 diabetes found the oral drug controlled blood glucose and increased fat burning, while animals retained muscle mass.
The research was led by scientists at Karolinska Institutet and Stockholm University in Sweden.
Shane C. Wright, assistant professor at the department of physiology and pharmacology at Karolinska Institutet, said the medication has the potential to be of “great importance” for patients with type 2 diabetes and obesity.
“Our substance appears to promote healthy weight loss and, in addition, patients do not have to take injections,” he added.
Human participants showed good tolerability and safety profiles, with fewer side effects than semaglutide and tirzepatide, which are known to cause appetite loss, gastrointestinal problems and muscle loss.
The medicine uses a new form of beta-2 agonist (a compound that stimulates muscle activity), reportedly avoiding overstimulation of the heart that has been a safety concern with older versions.
Because it works via a different mechanism to appetite-suppressing medicines, it could be used alone or alongside GLP-1s.
“Our results point to a future where we can improve metabolic health without losing muscle mass,” said Tore Bengtsson, professor at the department of molecular bioscience at Wenner-Gren Institute, Stockholm University.
“Muscles are important in both type 2 diabetes and obesity, and muscle mass is also directly correlated with life expectancy.”
Dr Trey Wickham, interim chief of the division of endocrinology, diabetes and metabolism at VCU Health in Richmond, Virginia, who was not involved in the study, said the compound’s mechanism could address specific metabolic concerns with previous weight reduction therapies.
“Although the reported preliminary results are interesting, rigorous testing involving larger longitudinal trials are necessary to ensure human long-term safety and understand the potential role of this compound in the comprehensive, evidence-based treatment of obesity and diabetes,” he said.
The researchers noted limitations, including that mouse studies cannot capture the complexity of human disease.
Structural studies are needed to confirm how the drug works, and conclusive clinical efficacy data on glucose control are still lacking.
Atrogi AB, the company that developed the drug, plans a larger phase 2 clinical trial with a more diverse population, including people with obesity.
