Finding an alternative purpose for the antihypertensive medication, verapamil, in treating type 2 diabetes
|
Reviewed by Dat Tien Nguyen, B.A, ScM.
|
Posted on December 9th, 2022
|
Verapamil is a phenylalkylamine calcium channel antagonist that are frequently used to manage cardiovascular conditions such as arrhythmia, hypertension and angina. As an unintended effect, the agent inhibits the production of proapoptotic thioredoxin-interacting protein (TXNIP). Which overexpression leads to accumulation in the pancreas, resulting in increased oxidative stress that kills beta cells. A recent study has investigated the potential usage of Verapamil in managing type 2 diabetes.
The clinical trial included 184 adults that had been diagnosed with type 2 diabetes for at least 12 weeks, with a Hb1Ac level between 7%-10% and a fasting plasma glucose (FPG) less than 260 mg/dL. Their condition had been managed with a minimum metformin dose of 1500 mg/day with no side effects for at least 12 weeks. To further ensure the participants’ health, the trial only included those who have a normal renal and hepatic function. Verapmil was administered orally in the form of pills, and the trial compared the efficacy of 3 different dosages (150 mg/day, 300 mg/day, and 450 mg/day) between each other and against a placebo. The treatment lasted for 12 weeks, and the researchers reported a slight 0.07% increase in Hb1Ac in the group using placebo. Whereas, usage of 300 and 450 mg of Verapamil was effective in reducing the Hb1Ac level by 0.28% and 0.37% respectively. By the end of the study, nearly 30% of those taking Verapamil managed to lower their Hb1Ac below 7%. Further subgroup analysis found that verapamil is the most effective in patients with a Hb1Ac level above 8%, a fasting plasma glucose level above 130 mg/dL, and with beta cell function lower than the median - measured using HOMA2-β. This indicates that the medication is the most effective at managing glycemic level in patients with moderate-to-severe type 2 diabetes. These results are promising since Verapamil results in little adverse events. Further studies are needed to assess the long term effectiveness and safety of the medication on the health of a larger population.
The clinical trial included 184 adults that had been diagnosed with type 2 diabetes for at least 12 weeks, with a Hb1Ac level between 7%-10% and a fasting plasma glucose (FPG) less than 260 mg/dL. Their condition had been managed with a minimum metformin dose of 1500 mg/day with no side effects for at least 12 weeks. To further ensure the participants’ health, the trial only included those who have a normal renal and hepatic function. Verapmil was administered orally in the form of pills, and the trial compared the efficacy of 3 different dosages (150 mg/day, 300 mg/day, and 450 mg/day) between each other and against a placebo. The treatment lasted for 12 weeks, and the researchers reported a slight 0.07% increase in Hb1Ac in the group using placebo. Whereas, usage of 300 and 450 mg of Verapamil was effective in reducing the Hb1Ac level by 0.28% and 0.37% respectively. By the end of the study, nearly 30% of those taking Verapamil managed to lower their Hb1Ac below 7%. Further subgroup analysis found that verapamil is the most effective in patients with a Hb1Ac level above 8%, a fasting plasma glucose level above 130 mg/dL, and with beta cell function lower than the median - measured using HOMA2-β. This indicates that the medication is the most effective at managing glycemic level in patients with moderate-to-severe type 2 diabetes. These results are promising since Verapamil results in little adverse events. Further studies are needed to assess the long term effectiveness and safety of the medication on the health of a larger population.