Diabetes drugs and Parkinson’s
Why are diabetes drugs being investigated as potential treatment options for Parkinson’s?
There is strong evidence that diabetes and Parkinson’s may be connected.
Research has shown that:
- People with type 2 diabetes have an increased risk of developing Parkinson's. And the risk is even higher for those who’ve had type 2 for 10 years or more.
- People with Parkinson's who also have diabetes may experience more severe motor and non-motor symptoms.
- People with Parkinson's who don't have diabetes may not respond to insulin as well as they should.
What’s behind the connection?
In diabetes the body doesn't produce enough or any of the hormone insulin or the body doesn’t respond to it normally. This means that glucose in the blood cannot be used by cells and doesn’t get stored away.
Brain cells need lots of glucose. It’s the fuel they use to generate the energy they need to function.
Dopamine-producing brain cells (those that stop working properly and are lost in Parkinson’s) have a particularly heavy workload. So, people with diabetes may be at greater risk of getting Parkinson’s, because dopamine-producing brain cells are particularly vulnerable if they can’t produce enough energy.
Could diabetes drugs work for Parkinson’s?
This connection between diabetes and Parkinson’s has led to important research to investigate whether drugs used by people with type 2 diabetes could help to protect the brain cells affected in Parkinson’s and thereby slow or stop the progression of the condition.
A particular type of diabetes drugs have been the focus of this research. These drugs help in diabetes by targeting the glucagon-like peptide-1 (GLP-1) receptor in the pancreas which stimulates the release of insulin and therefore helps cells absorb more glucose from the blood.
Importantly for Parkinson’s, the same GLP-1 receptors that are found in the pancreas are also found in the brain.
Experiments carried out in the lab have shown that these drugs have powerful beneficial effects on dopamine-producing brain cells. These promising results have led to trials of GLP-1 receptor targeting drugs to see if they can slow or stop the progression of Parkinson’s in people.
Results from clinical trials to date
Three different GLP-1 drugs have been tested in people with Parkinson’s so far. Let’s review the topline results.
Lixisenatide (2024)
What?
A phase 2 trial in France in 156 people with Parkinson’s who were less than 3 years into their diagnosis. Participants received daily injections of lixisenatide or placebo over 12 months.
Positives?
Movement symptoms in people with Parkinson’s receiving lixisenatide treatment did not deteriorate over a 12 month period, compared to those receiving a placebo where there was a slight worsening.
Question marks?
The study didn’t show any benefit to quality of life or non-motor symptoms in those receiving lixisenatide compared to placebo.
Read more about the 2024 lixisenatide results in our research news story.
Liraglutide (2022)
What?
A phase 2 trial in the USA of 63 participants where people were given either once-daily injections of liraglutide or placebo injections for 52 weeks.
Positives?
Improvements were seen in non-motor symptoms and quality of life in those who received liraglutide compared to placebo.
Question marks?
However, there was no clear improvement in movement symptoms between those on liraglutide and those on the placebo.
Exenatide Phase 2 (2017)
What?
A phase 2 trial in the UK in 60 people with Parkinson’s. Half injected themselves with exenatide once a week for 48 weeks. The other half (the placebo group) injected a dummy version of the drug.
Positives?
Those who received exenatide had a slight improvement when their movement was assessed while off their regular Parkinson’s medication and this difference between the two groups was still there 12 weeks after treatment had been stopped.
Question marks?
There was no effect on quality of life or non-motor symptoms.
Exenatide Phase 3 (2024)
What?
Funded by the National Institute for Health and Care Research (NIHR), 194 individuals with Parkinson’s took part in the 96-week trial.
Results?
Results from the phase 3 trial have been shared with participants but full results are yet to be published. The results indicate that people in the study who received exenatide did not benefit compared to those who received placebo - suggesting that the drug does not slow down the progression of Parkinson’s.
Read more about the exenatide-PD3 update to participants in our research news story.
What’s next for diabetes drugs and Parkinson’s?
It’s too soon to say what the latest results mean for wider research into the potential of diabetes drugs for Parkinson’s. We await the full published results from the phase 3 exenatide trial to fully discuss, reflect upon and learn from the findings together.
Note: It is essential that drugs are properly tested to ensure that they are safe and beneficial for people with Parkinson’s and do not interact with any other medication that they are on. We would not recommend people to go out and take these drugs, unless they have been recommended by a medical professional for other reasons.