Alzheimer's-as-diabetes debate

by The Star-Ledger Business Desk Friday December 07, 2007, 8:36 AM
Scientists have been searching for the cause of Alzheimer's disease for more than 100 years, and during that time, theories about why brain cells are destroyed in the course of the illness have come and gone. One of the newer and more unorthodox theories posits that Alzheimer's may actually be a form of diabetes, BusinessWeek reports. Some experts have even taken to calling the brain disease type 3 diabetes, as distinct from the insulin-dependent (type 1) and adult-onset (type 2) varieties of the condition.

The diabetes hypothesis stems from growing evidence that cells in the brains of Alzheimer's victims are resistant to insulin; just as in diabetes, the cells don't respond appropriately to this hormone. As a result, neurons are deprived of glucose, which they need for energy. As the evidence mounts, the type 3 label is gaining currency in Alzheimer's research circles and is drawing attention from the pharmaceutical industry. Pharma companies are testing existing diabetes drugs against Alzheimer's, while startup Acumen Pharmaceuticals, in partnership with Merck (MRK), is focusing on molecules that allow insulin to reach brain cells.

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If the fundamental understanding of Alzheimer's disease shifts in this direction, it could have a big impact on GlaxoSmithKline's (GSK) floundering diabetes drug, Avandia. Sales have dropped dramatically in recent months over concerns that the drug raises the risk of heart attack and bone disease in diabetics. But last year, a small clinical trial yielded intriguing evidence that Avandia might slow the progress of Alzheimer's. Glaxo is now testing the drug against a placebo on 3,400 Alzheimer's patients, with results expected in 2009
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