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Pills, pills, pills. It seems every ailment — from headaches to high blood pressure — needs them. But, what if you could swap the medication for vegetables?
An international group of researchers envision such a future for type-2 diabetics based on new results published Wednesday in the journal Science Translational Medicine. Their findings show how a compound found in broccoli improves diabetic outcomes to an extent that rivals the go-to drug treatment, with fewer severe side effects.
“To many patients, it might be more attractive to take a broccoli shot or drink than having to take another pill,” said Anders Rosengren, at the University of Gothenburg in Sweden and the study’s senior author.
Diabetes afflicts more than 400 million people worldwide, four times as many people as in 1980. Part of the problem is the disease can progress unnoticed for years, even decades, until severe complications like compromised kidney function arise.
“It’s why we need to be so active with this disease so we have the proper treatment at early stages,” Rosengren said.
Their project wants to find an alternative for metformin, a gold-standard drug that tackles a hallmark of diabetes: runaway production of glucose in the liver. Insulin normally keeps glucose on a tight leash, but becomes dysregulated in diabetes. Although metformin works well, it has a few problems.
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“One problem is that it cannot be taken by people with poor kidney function,” Rosengren said, yet poor kidney function is one of the most common complications of type-2 diabetes. And metformin can cause side effects — including stomach pain, bloating and diarrhea — in some patients.
Diabetes is not attributable to one gene, but rather a collection. So Rosengren and his colleagues wanted a drug that could modify a network of diabetes-related genes. A preliminary test, associating a set of 50 liver genes involved in type-2 diabetes and 3,800 drugs, landed on a compound called sulforaphane. Sulforaphane is found in cruciferous vegetables, like broccoli, and has improved insulin responses in diabetic rats in previous studies.
To determine if sulforaphane modifies blood sugar levels, the researchers completed a series of investigations before conducting a human trial.
Early tests showed that sulforaphane could prevent glucose overproduction in liver cells grown in petri dishes. Next, the team tried their luck in rodent models of diabetes. There, they found sulforaphane both prevented the development of glucose intolerance, a hallmark of diabetes, and lowered blood glucose levels as much as metformin did.
Emboldened by these positive results, the researchers recruited 97 type-2 diabetics from Sweden to take daily doses of sulforaphane — in the form of a highly concentrated, liquid broccoli sprout extract — or a placebo for 12 weeks.
Only the patients who took broccoli extract showed a clear reduction in blood sugar levels.The broccoli extract was most effective for overweight patients with unmanaged type-2 diabetes. Plus, no patients on the broccoli regimen reported severe or lasting side effects during the three-month study.
“Alongside the other lifestyle things like physical activity and not eating a whole lot of refined sugars, this could be a promising therapy,” said Chris D’Adamo, an epidemiologist and healthy lifestyle expert at the University of Maryland School of Medicine, who was not involved in the study. “It needs to be replicated, [but] I was positively surprised by the degree of efficacy that it showed and the lack of noticeable side effects.”
But before you rush to the grocery store, know that the amount of sulforaphane taken by the patients was approximately 100 times that found naturally in broccoli — or the equivalent of consuming 11 pounds of broccoli per day.
Rosengren is encouraged by the results, but advises that people should wait for drug regulators to approve broccoli sprout extract for type-2 diabetes before they rush to try the treatment.
“It has the potential to become an important complement to existing treatment options for type-2 diabetes,” Rosengren said.
Roni Dengler is a 2017 AAAS mass media science & engineering fellow. She recently earned a doctorate in molecular, cellular and developmental biology from the University of Colorado Boulder. Beyond the lab bench, she acted as editor-in-chief for a graduate student-run blog Science Buffs and co-organized several science and science communication symposiums, including the upcoming ComSciCon Rocky Mountain West.
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