Note to users. If you're seeing this message, it means that your browser cannot find this page's style/presentation instructions -- or possibly that you are using a browser that does not support current Web standards. Find out more about why this message is appearing, and what you can do to make your experience of our site the best it can be.
Subscribe

Logo for

Science 331 (6024): 1529-1531

Copyright © 2011 by the American Association for the Advancement of Science

Selective Insulin Sensitizers

Ja Young Kim-Muller, and Domenico Accili

Type 2 diabetes mellitus and its complications are, with cardiovascular diseases, leading threats to public health in the 21st century. In the United States, type 2 diabetes care accounts for a third of federal health insurance (Medicare) expenditures—nearly half of it to treat associated macrovascular problems (1). The cornerstone of type 2 diabetes is insulin resistance—a decreased sensitivity of tissues and organs, such as the liver, to the metabolic effects of the hormone insulin (the other major cause is failure of the pancreas to produce insulin). Yet, except for thiazolidinediones—whose checkered safety history, troublesome side effects, and regulatory setbacks stifled widespread adoption by clinicians—treatment options for insulin resistance have generally remained unchanged since the 1940s. Although insulin signaling pathways in cells have been largely deciphered (2), the key mediators of insulin signaling are poor drug targets because they either lack a suitable ligand-binding domain, or are shared with other cellular pathways that regulate cell growth and proliferation. This realization spawned research into "alternative pathways" that control insulin resistance. On page 1621 of this issue, Kir et al. (3) find that human fibroblast growth factor 19 (FGF19) can boost certain effects of insulin on the mammalian liver, raising interest and questions about possible therapies involving this molecule.

Department of Medicine and Berrie Diabetes Center, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.

E-mail: da230{at}columbia.edu

To Advertise     Find Products

Science Signaling. ISSN 1937-9145 (online), 1945-0877 (print). Pre-2008: Science's STKE. ISSN 1525-8882