Your Intestines Can Taste Sugar

A friend recently called my attention to an on-line Scientific American article titled "Your Intestines Can Taste Sugar".

Wow; I had thought the taste buds were in one's mouth, not one's gut! However, the more I looked at the story, the less I was impressed with gut-tasting-sugar concept, and the more I was impressed with the creativity of press agents promoting another me-too diabetes drug in development; in this case, another tweak on extended-release metformin.

Metformin has been one of the mainstay drugs in the treatment of type 2 diabetes for many years, and is frequently recommended to start at the time of initial diagnosis. Extended-release versions have long been available under trade names such as Glucophage XR (XR stands for extended release, not X-Ray: get it?). The extended-release version releases the drug more slowly, which helps decrease the gastrointestinal side effects of diarrhea and belly pain. And once-daily dosing is easier to handle then three-times dosing with the plain-jane version of metformin.

So what's with this new version of metformin that (according to the Scientific American writer) "targets the taste receptors"? Apparently, "Three years ago researchers... made a shocking discovery: our guts can taste sugar. Just like the tongue, the intestines and pancreas have sweetness receptors that can sense glucose and fructose." Yes, shocking to the reporter, but no, not of any practical interest to me nor to other people with diabetes -- we're certainly not going to choose whether to eat candy or ice cream or pie based on whether the gut can sense sweetness (if indeed it can).

Was this story actually authored by a SA author, or was it ghost-written by a press flack for a pharmaceutical company? I suspect it was a flack: the tip-off is the brand name for the ER metformin is quoted in the story. Usually, drug companies are careful not to quote the proposed trade name for their product until the drug is approved by the FDA and/or other countries' Health Authorities. And this version of metformin hasn't yet been approved, per the company's website; it is only "entering Phase 2b development."

There are a few abstracts and publications about this version of metformin on line, and four trials listed at ClinicalTrials.gov, but there's nothing I can see that indicates any desire of the manufacturer to evaluate your gut's ability to taste sugar; the trials are all the standard sort of preliminary studies that one would expect to be done for any new diabetes drug.

For Scientific American to promote some drug company's me-too metformin with such a misleading (although catchy) title is sad. As my friend pointed out, "So many people have looked to them [Scientific American] for good reporting... I looked at that [story] as a snake oil sales job... Scientific American should know better then this..." Yes, they should.

Finally, can your gut actually taste sugar? If it can, there's nothing in this story, or in the development of this version of metformin, to answer either yes or no.