The Pill

Dolors & Sense

by Sanford Rose

KISSIMMEE Florida—(Weekly Hubris)—3/26/12—No, this isn’t about contraception. It’s about proception.

And not life in the form of a new individual. But rather life in the form of a revitalized older one.

This pill is not anti-anything. It is the anti-anti-pill.

This pill (of the future, perhaps very near future) could help diabetics overcome insulin resistance.

Diabetes is, in large measure, a disease of impaired energy metabolism.

The typical adult-onset diabetic starts with obesity and ends up in substantial disability.

At a certain stage, bloated fat cells are no longer able to contain the excess calories; the lipids spill out and invade the muscles, the action of which they impede.

Thus, fat leads to diminished activity, which leads to more fat, etc.

. . . the familiar vicious cycle, a reverse run of the virtuous cycle of lean body mass, which facilitates exercise, which increases fuel-burning capacity, which creates still greater exercise tolerance, which produces still more lean body mass.

Along come some scientists, who have managed to isolate a muscle-metabolism-regulating protein, dubbed PGC-1. Via genetic manipulation, they “overexpress” it in laboratory mice.

Result: murine marathoners that can’t be bumped off their treadmills.

An examination of the musculature of these obligate athletes reveals more endurance-producing fibers, more fuel-burning mitochondria, and a richer blood supply than in their normal brethren.

Then the scientists engineer other mice to “underexpress” PGC-1.

Result: murine couch potatoes that can’t be induced to get on the treadmill and whose musculature pales in comparison with that of the control group.

Interestingly, the sluggards don’t necessarily gain weight . . . suggesting that the scientists have managed to separate the fit factor from the fat factor.

Does this mean that, if the murine results pan out in human trials, people with diabetes can continue eating what they want and simply reverse the impact of obesity on muscular state and function by popping a PGC-stimulating pill?

Hardly. Nor does it mean that people can dispense with exercise, which has now been shown to confer cognitive as well as skeletal and cardiovascular benefits.

But it certainly offers a glimmer of hope of pharmacological recovery to many whose bodies have been ravaged by diabetic decay and who have hitherto despaired of remedy.