Is Broccoli an Answer for Those Who Can't Tolerate Metformin?

The researchers' approach to finding the compound could be used to find cures in other diseases.

For those who have type 2 diabetes (T2D), the first drug given is typically metformin. But up to 15% of patients can’t tolerate it, and researchers have been looking for another low-cost first step for treatment.

Could the answer be broccoli?

Annika S. Axelsson of the Lund University Diabetes Center in Malmo, Sweden, and colleagues decided to take a systematic approach to finding a compound that would have the properties needed to treat T2D naturally.

First, they analyzed the pattern of gene expression associated with T2D; then, they scoured a library of 3800 drug signatures, which identified sulforaphane as a compound that could reverse the gene signature for T2D uncovered in the first phase of research.

Sulforaphane, a phytochemical in broccoli sprouts, was recently identified as a possible agent for cancer prevention because of its antioxidant qualities; in experiments with mice, it also worked against obesity by improving gut bacteria to promote energy consumption.

Now, it appears that broccoli sprout extract could also be an agent to reduce fasting blood glucose and glycated hemoglobin (A1C). First, the researchers found that sulforaphane reined in glucose production in liver cells growing in a culture; then, they used it to reverse disease signatures in diabetic rats.

Finally, the team tested concentrated broccoli sprout extract in a randomized controlled trial with 97 patients with T2D over 12 weeks. Of those taking the broccoli sprout substance, 60 had well-regulated T2D and 37 had uncontrolled T2D. Among the latter group, 17 were obese and 20 were not. The obese participants who entered the study with uncontrolled diabetes significantly reduced their fasting blood glucose levels, relative to the other participants. Best of all, the broccoli extract was well-tolerated.

The researchers, who published their work in Science Translational Medicine, said theirs is “a potentially useful approach for drug discovery,” allowing a systematic way to connect compounds with diseases in need of novel cures.

Reference

Axelsson AS, Tubbs E, Mecham B, et al. Sulforaphane reduces hepatic glucose production and improves glucose control in patients with type 2 diabetes [published June 14, 2017]. Sci Transl Med. DOI: 10.1126/scitranslmed.aah4477.