A natural, non-toxic byproduct of glucose may prevent brain cell death and cognitive impairment in diabetics following an episode of severely low blood sugar, according to researchers at the
San Francisco VA Medical Center (SFVAMC).
In research studies with rats, senior investigator Raymond A. Swanson and lead author Sang Won Suh demonstrated the effectiveness of pyruvate, a naturally-occurring byproduct of glucose, when administered along with glucose after 30 minutes of diabetic coma. The therapy prevented brain damage and subsequent memory and learning impairment far better than treatment with glucose alone.
The study findings, appearing in the May 1, 2005 issue of
Diabetes, have direct implications for the treatment of diabetic patients in hypoglycemic coma, according to the researchers.
Glucose is a form of sugar that serves as the body's primary fuel. People with diabetes lack the ability to make insulin, the primary enzyme that metabolizes glucose and regulates its levels in the blood, and must inject insulin to make up for this lack. Abnormally low blood glucose is called hypoglycemia; severe hypoglycemia can cause coma.
"It's estimated that between 2 percent and 15 percent of people with diabetes will have at least one episode of diabetic coma resulting from severe hypoglycemia," says Swanson, chief of the Neurology and Rehabilitation Service at SFVAMC and professor of neurology at UCSF.
"Anybody who's worked at a busy emergency room has seen a patient like this," he adds. A patient admitted with severe hypoglycemia is immediately given glucose as a standard treatment. This restores consciousness right away, but may not always prevent the subsequent death of neurons and possible cognitive impairment, he says.
The current study findings have set the stage for two lines of future research, according to Swanson. One will involve the study of animals under circumstances less severe, and more realistic, than a 30-minute coma: "At this point, we need to also examine the effect of pyruvate after more moderate hypoglycemia, as more commonly experienced by diabetic patients."
At the same time, Swanson believes that research on pyruvate therapy is ready to advance to the clinical level. "Pyruvate is a natural metabolite, present in our blood. There's no reason to think that it would have any long-term adverse effects."
Source: Steve Tokar
