Co-led by UNC School of Medicine’s John Buse, MD, PhD, researchers discover how treatment of hypercortisolism could improve glucose control and promote weight loss in diabetes.
One of the biggest struggles for people with type 2 diabetes is to manage blood glucose levels to the general target of less than 7% on the A1c test. About half of people with type 2 diabetes do not achieve an A1c less than 7.5%, even though many are treated intensively with substantial lifestyle efforts and multiple medications. The effects can lead to many people developing complications of diabetes over years.
In Phase 1 of the CATALYST study, research led by John Buse, MD, PhD, director of the University of North Carolina’s Diabetes Center, revealed that nearly 1 in 4 people with difficult to control diabetes had hypercortisolism – a condition characterized by abnormally high levels of the hormone cortisol in the body.
Now, new findings uncovered in Phase 2 of the CATALYST study suggest the use of the drug mifepristone (brand name Korlym) can help lower blood glucose levels and weight of type 2 diabetes patients who have hypercortisolism.
The new results showed that patients treated with mifepristone had a 1.5% reduction in A1c, on average nearly to the target of 7%. The reduction was much greater than with placebo or inactive tablets. This outcome occurred despite many patients on mifepristone decreasing or even stopping other diabetes medications, including insulin. In addition, research indicated this A1c reduction was also associated with weight loss and reduction in waist size.
“This is proof of a new paradigm in diabetes care, and this is an example of precision, targeted care,” said Buse. “If you treat the hypercortisolemia, you may benefit many processes beyond A1c and weight loss. The second phase of this trial indicates that with more study and greater art in practice, cortisol-directed therapy in difficult-to-control diabetes will be transformational in diabetes care practices and people’s lives.”
Phase 2 study results were presented today at the American Diabetes Association 85th Scientific Sessions.
Media contact: Brittany Phillips, Communications Specialist, UNC Health | UNC School of Medicine