Bromocriptine-QR (Cycloset)

In a recent article published in the journal Diabetes Care, researchers from Israel reported on a case of a female adolescent with type 1 diabetes who was intentionally omitting insulin in an attempt to lose weight. The adolescent was treated with an advanced hybrid closed-loop system (AHCL), which is a …

Sponsored Content  Bromocriptine-QR (Cycloset) “is a sympatholytic dopamine D2 agonist for the treatment of type 2 diabetes that has demonstrated rapid (within 1 year) substantial reductions in adverse cardiovascular events in this population by as yet incompletely delineated mechanisms.” This study investigated the impact of Cycloset on the pro-inflammatory state …

by Anthony H. Cincotta, PhD
This is the third in a recurring series of articles on Dr. Cincotta’s work on the brain dopamine clock and type 2 diabetes. In this installment, targeting chronically elevated sympathetic tone to improve glycemic control and cardiometabolic health in type 2 diabetes patients.

As concluded in the previous newsletter in this series, “Evolutionary selection for insulin resistance in a cyclic environment: brain clocks and control of peripheral metabolism” the brain is equipped with circadian neurophysiological mechanisms to induce (and reverse) the insulin resistant state that evolved as a survival strategy against ensuing environmental stresses such as prolonged (seasonal) lack of food availability. A central facilitator of this insulin resistance induction is a diminution of the circadian peak in dopaminergic activity at the SCN. Neurotoxin induced destruction of these dopaminergic projections to the clock of insulin sensitive animals induces marked insulin resistance and glucose intolerance without alterations in food consumption.

Given the potential for CVD risk reduction associated with metformin and B-QR therapy individually, the present study explored the effect of add-on B-QR vs placebo to metformin on CVD outcomes in T2DM subjects.

In part 2 of this exclusive ADA interview, Anthony Cincotta discusses the Cycloset Safety Trial study design and findings regarding the cardiovascular safety of Cycloset.

In part 1 of this exclusive ADA interview, Anthony Cincotta discusses the mechanistic science behind the development of Cycloset, and why preclinical and clinical findings suggest the therapy may reset clock mechanisms governing postprandial glucose metabolism.

The prevalence of obesity and insulin resistance syndrome, rare only a century ago in most geographic locals of the world are now disorders whose prevalence represents the majority of humans in westernized countries on planet Earth. This simple observation strongly suggests that factors other than or in addition to genetic mutations/alterations are facilitating this rapid onset in disease occurrence world wide. Although the insulin resistance syndrome is viewed by the medical community as a defect of normal physiology, a plethora of available evidence indicates that the insulin resistant condition evolved among vertebrates as a survival strategy to enable increased survivability of ensuing, predictable seasons of low/no food (including glucose) availability.

I am a neuroendocrinologist by training, having received my Bachelor’s degree in biochemistry and molecular biology from the University of California, Santa Barbara and Master’s and Doctorate degrees from Louisiana State University (LSU) in physiology under the mentorship of Dr. Albert H. Meier. It was at LSU that my interest in the biological clock system and its role in the regulation of metabolic physiology was sparked by the revolutionary discoveries and elucidations made by Dr. Meier’s lab concerning biological clock mechanisms regulating physiology. He and his group in the early 1960s were the very first to demonstrate the existence in any organism of circadian rhythms of physiological responses to neuroendocrine factors. At LSU, I began investigating the possibility that modern human pathology of the metabolic syndrome (and several other progressive pathologies) was not a result of any “genetic defect” but of an environmentally induced (e.g., diet, stress, sleep-wake architecture) alteration of circadian neuroendocrine information presented to the clock system that then responded to direct the body to the obese/insulin resistant state as a survival response to such information.

Szilard Voros, MD, discusses the drug Cycloset (a central dopamine agonist) and its possibilities for improving both cardiovascular and diabetic health. He talks about how Health Diagnostics Laboratory sees a very specific role and niche for this particular drug because of a specific biomarker they have identified. Other videos with Dr. …