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The Gila monster and GLP-1: how a lizard's venom became a diabetes drug
GLP-1, the fullness hormone of your gut, lowers blood sugar, but your blood destroys it in about two minutes. The way around it came from the venom of a big, slow desert lizard.
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In the 1980s, scientists found GLP-1. In the early 1990s, they gave it to people with type 2 diabetes. It lowered their blood sugar. It looked like a great medicine.
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But your blood holds an enzyme, a tiny cutting tool. It snips the front end off GLP-1, and without that end, the key no longer works. Within a minute or two, half of the GLP-1 is cut.
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In tests, people had to get GLP-1 nonstop, through a drip. That is no way to treat millions of people.
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The answer came from the desert. The Gila monster lives in the southwestern United States and in Mexico. It is a big, slow lizard with a venomous bite, and it spends most of its life in a burrow.
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In 1992, John Eng, a doctor at a hospital for veterans in New York, studied the venom of the Gila monster. In it, he found a new molecule, and he named it exendin-4.
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Exendin-4 looks a lot like GLP-1, and it turns the same lock. But its front end is a little different, so the enzyme cannot cut it. It keeps working for hours, not minutes.
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A lab-made copy of exendin-4 became the first GLP-1 medicine, approved in the United States in 2005. Its name is exenatide. People with diabetes took it as a shot twice a day, before breakfast and before dinner.
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So that first medicine lasted hours, and it needed two shots a day. Rono's shot works for a whole week, and it is not made from the lizard's molecule at all.
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