Iciar Aviles-Olmos, John Dickson, Zinovia Kefalopoulou, Atbin Djamshidian, Peter Ell, Therese Soderlund, Peter Whitton, Richard Wyse, Tom Isaacs, Andrew Lees, Patricia Limousin, Thomas Foltynie
Submitter: David Keller | DavidLouisKeller@gmail.com
Providence Medical Group
Published June 6, 2013
The possible beneficial effect of exenatide on the progression of Parkinson disease might have been due to the mild sustained decrease in blood glucose levels which is the usual intended effect of this medication in diabetics, or to the pleiotropic effects cited by the investigators, or to a combination of effects. This question could be answered by comparing exenatide to sitagliptin, an oral glucose-lowering medication which works on the incretin system in a different fashion, or to a low-dose of extended-release metformin, which lowers blood sugar independent of the incretin system. It is reasonable to hypothesize that a slight lowering of blood glucose (within the normal range) might be neuroprotective by means of slowing metabolism, decreasing the generation of free radicals, and other effects not unique to exenatide. Fortunately, these agents are all considered unlikely to cause hypoglycemia. Would such a study be worthwhile?