Co-led by John Buse, MD, PhD from the UNC School of Medicine, a recent study has shown promising results for patients with type 2 diabetes who struggle to manage their condition. The study focuses on the treatment of hypercortisolism and its potential benefits in improving glucose control and promoting weight loss.
According to Dr. Buse, managing blood glucose levels to the general target of less than 7% on the A1c test is one of the biggest challenges for people with type 2 diabetes. About half of these patients do not achieve an A1c less than 7.5%, despite intensive treatments involving lifestyle changes and multiple medications. This difficulty can lead to complications over time.
In Phase 1 of the CATALYST study, researchers found that nearly one in four individuals with difficult-to-control diabetes had hypercortisolism—a condition marked by high cortisol levels in the body.
Phase 2 of the CATALYST study revealed that using mifepristone (Korlym) could lower blood glucose levels and reduce weight in type 2 diabetes patients with hypercortisolism. The findings showed an average reduction of 1.5% in A1c levels among those treated with mifepristone, nearing the target level of 7%. This was a more significant reduction compared to placebo or inactive tablets, even as many patients reduced or stopped other diabetes medications like insulin. Additionally, this reduction was linked to weight loss and decreased waist size.
“This is proof of a new paradigm in diabetes care, and this is an example of precision, targeted care,” said Buse. “If you treat the hypercortisolemia, you may benefit many processes beyond A1c and weight loss. The second phase of this trial indicates that with more study and greater art in practice, cortisol-directed therapy in difficult-to-control diabetes will be transformational in diabetes care practices and people’s lives.”
The results from Phase 2 were presented at the American Diabetes Association’s 85th Scientific Sessions.
