Using a Drug for Sexual Dysfunction Against Type 2 Diabetes

Can an aphrodisiac help people with type 2 diabetes?

Stanford researchers are currently investigating whether a cancer drug can work against Ebola, and Viagra was originally not designed to help men with erectile dysfunction, so the notion that a drug commonly used as an aid in sexual dysfunction could help people with type 2 diabetes isn't all that strange.

The 'aphrodisiac' in question is the stimulant yohimbine, said to have both aphrodisiac effects as well as mild monoamine oxidase inhibitor (MAOI) effects. Right now it is used for both sexual dysfunction and for the treatment of xerostomia, more commonly known as dry-mouth.

But the results of a small study of 50 type 2 diabetes patients suggest it might help in improving insulin secretion.

Specifically, people in the study who carried a mutation in the ADRA2A gene had improved insulin secretion 30 minutes after a glucose load compared with those without the mutation.

About forty percent of people with type 2 diabetes carry a single nucleotide polymorphism (SNP) in the ADRA2A gene (rs553668), which causes over-expression of the alpha(2A) adrenergic receptor. This mutation leads to impaired insulin secretion.

The question then became, how to go about blocking this over-expressed receptor? The idea was to use a known alpha(2A) antagonist to block it, and they had one in yohimbine.

Reporting their findings in the journal Science Translational Medicine, researchers from Lund University in Sweden, and colleagues wrote that, "These findings represent the first example of pharmacological targeting of a specific disease mechanism for type 2 diabetes coupled to a common genetic variant."

The results weren't without side effects, though, as a small number of patients experienced high blood pressure, and one drawback to yohimbine is the fact that it is anxiogenic-- meaning that it can cause anxiety.

Of course, since it is used in the treatment of sexual dysfunction (in males), it can also cause an erection, which is context-specific in terms of whether good or bad.

However, looking long-term, this study is a good step towards the use of known genetic risk variants as guides for targeted therapies and it hints at the potential for treating type 2 diabetes down the road with genotype-specific, individualized medicine.