adiponectin and diabetes

a new article appeared in Nature which may be an important breakthrough in diabetes care/prevention in the future, targeting probably the primary pathophysiologic disturbance in the development of type 2 diabetes (see dm adiponectin analog nature 2014 in dropbox, or doi:10.1038/nature12656). adiponectin has been known for years as a naturally occurring hormone produced in adipocytes, with lower levels found in obese people and those with diabetes. there is a strong relationship between lower adiponectin levels and visceral adiposity as well as the development of insulin resistance, and by increasing adiponectin levels there is improved insulin sensitivity (presumably through increasing fatty acid oxidation and inhibition of hepatic glucose production) and lowered blood glucose levels. adiponectin levels are increased by the glitizones and that may be their mechanism to improve insulin sensitivity. in addition adiponectin has anti-inflammatory and anti-atherogenic effects in several studies.
 
with this background, there was this japanese study of a molecule (AdipoRon), an oral adiponectin analog, which stimulates both of the known adiponectin receptors. this med was found to improve insulin resistance and glucose tolerance when normal mice were fed a high-fat diet, to improve diabetes in genetically obese mice, and to prolong the otherwise shortened life span in these genetically obese mice fed a high-fat diet.
 
so, fyi. the main reason i am sending this out is that, to me, having low adiponectin levels is associated with the development of many of the characteristics of metabolic syndrome and diabetes, and at least theoretically increasing the adiponectin effect medically may be an important future intervention in preventing the development of type 2 diabetes and its complications. (of course, it would be even better if we could develop a comprehensive public health program to decrease obesity and increase exercise in the population as a whole, which is even more physiologic.....).

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