Shining a New Light in the Diabetes Fight

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Diabetes is a growing problem across the world, especially in the United States where more than 1.4 million people are diagnosed with the disease each year. Anti-diabetic drugs have existed for decades, but are often accompanied by unpleasant side effects as they lower blood glucose levels.

In November 2015, a study co-authored by Dr. David Hodson investigated the signaling processes of cell receptors and the effectiveness of anti-diabetics triggered by blue or ultraviolet light. Light-activated drugs are designed to eliminate side effects and provide more efficient, targeted treatments, and they have the potential to do so for far more than just diabetes.

BTRtoday spoke with Hodson, a Senior Birmingham Fellow in Molecular Endocrinology, about the importance of the study and the potential for light-activated medicine in the years to come.

BTRtoday (BTR): What’s the main focus behind studying light-activated drugs?

David Hodson (DH): One of the things we’re more concerned about is the fact that if you treat people with conventional drugs, the drug will act on every cell in the body basically. In some cells it will have bad effects whereas in other cells it will have the good effects, which you want it to have. That’s why you get side effects. That’s why if you take some of the anti-diabetics of the moment, you might have a higher risk of getting heart disease, or if you take painkillers you might have the chance of developing kidney or liver disease.

The premise here is if we can make the drugs activated by light, we can deliver the activity of the drugs precisely to where we want that to be–to the pancreas, to the heart, or to the site of pain, for example.

BTR: The medicine would be precise as far as where it would go; would it also be precise in terms of the amount administered?

DH: You can do both, yes. That’s the thing about drugs, often we’ll only want to take a drug twice a day, but actually it would need to be in the system for that long. So what we can do here is take a long-acting drug but just illuminate it for an hour or so, for example, just after a meal, and that will be sufficient to return your glucose levels back to normal, and that will keep your diabetes under control. And then the drug won’t be active.

BTR: Are there any other side effects that light-activated medication would eliminate from diabetes treatment?

DH: The major side effect that you tend to get with diabetes treatment at the moment is heart disease, and you also get a lot of undesirable effects like gastrointestinal disturbance and nausea. The reason for that is these drugs will act upon their targets in the brain and in the gut to make you feel like that, but for the treatment of diabetes they actually have to act in the brain or gut. So if you just target this drug where it needs to be and shine the light on the pancreas, for example, then you will eliminate those side effects.

The treatments do work, but a lot of people will eventually come off the treatments because they just don’t want to deal with vomiting, diarrhea, gastrointestinal upset, all of it. I think we lose a contingent of people because of this.

BTR: Given the elimination of side effects and how effective it can be in treating diabetes and possibly other illnesses, do you think that light-activation is the future of most medicine?

DH: When we began to do this, I think it was more curiosity driven, just to show that this could be done. But what we’re beginning to find is that more and more drugs are being targeted in this way, even while people might be a little reticent to think about it at the moment, and certainly drug companies will be reticent to think about it, I would say in the next 20 years I can see this going into clinical settings because there’s going to be less and less reason not to do it.

BTR: Would people have ultraviolet lights that come with the medication to illuminate it themselves?

DH: Basically what you can do is package the medicine into a device, which would be a little bit like having a flexible needle inside you, like how you would wear an insulin pump or a pacemaker. And it would just deliver the medicine and the light at the same time. We’ve not changed the way we think about drugs since they were invented. The time has sort of come now where we’re actually not finding that many more new drugs, but we have a lot of drugs which we know a lot about and which are very effective. So essentially we would be able to repurpose those drugs in this way to make them more efficient, reduce side effects, and I think that’s the exciting possibility.

BTR: With the growing rate of diabetes, how important is this kind of development as far as treating the disease?

DH: Originally when we started doing this, our basic premise was to understand how insulin is released, so we made these tools that allowed us to do that. There are drugs on the market now against diabetes, but we don’t really understand how these drugs work because we don’t really understand how the targeted receptor works. The research with the light-activated drugs helps to understand those mechanisms.

The other part is once we’ve understood the mechanisms, to package these up into potential treatments over the next 20-25 years. It’s a two-pronged approach. You would be amazed—you can get drugs for FDA approval for clinical trials and so forth without knowing how they work. Thalidomide is a classic case where all the testing was done on one isomer of the drug, and it turned out the other isomer caused huge birth defects after being prescribed to women with morning sickness around the world. Our own study of these mechanisms is pretty naive, and I think these tools will help us to increase that understanding, but will also stand to serve as potential treatments further down the line as well.

Especially in the United States where you have to pay for your healthcare. If you want the latest, greatest drug, you’ve got to be wealthy, have a good insurance package, and it’s not necessarily always the right thing for you to have anyway. Maybe it’s just something they’ve given you because you have the money to afford it. There’s a whole group of people that need cheaper drugs that work better. You can take this drug, we can make it more effective, and you can treat your diabetes for cents per day rather than dozens of dollars a day. So it’s also for getting the treatment for the people that need it.