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Glucokinase activation or inactivation: Which will lead to the treatment of type 2 diabetes?
Author(s) -
Nakamura Akinobu,
Omori Kazuno,
Terauchi Yasuo
Publication year - 2021
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14459
Subject(s) - glucokinase , diabetes mellitus , type 2 diabetes , endocrinology , beta cell , medicine , haploinsufficiency , glycolysis , glucose homeostasis , hexokinase , biochemistry , phenotype , chemistry , metabolism , insulin resistance , islet , gene
Glucokinase, which phosphorylates glucose to form glucose‐6‐phosphate, plays a critical role in regulating blood glucose levels. On the basis of data of glucokinase‐knockout and transgenic mice and humans with glucokinase mutations, glucokinase was targeted for drug development aiming to augment its activity, and thereby reduce hyperglycaemia in patients with diabetes. In fact, various small molecule compounds have been developed and clinically tested as glucokinase activators. However, some have been discontinued because of efficacy and safety issues. One of these issues is loss of the drug's efficacy over time. This unsustained glycaemic efficacy may be associated with the excess glycolysis by glucokinase activation in pancreatic beta cells, resulting in beta‐cell failure. Recently, we have shown that glucokinase haploinsufficiency ameliorated glucose intolerance by increasing beta‐cell function and mass in a mouse model of diabetes. Given that a similar phenotype has been observed in glucokinase‐activated beta cells and diabetic beta cells, glucokinase inactivation may be a new therapeutic target for type 2 diabetes.