A pilot study at the University of Gothenburg suggests that high-dose tadalafil, a drug commonly used to treat erectile dysfunction, may significantly improve long-term blood sugar levels in people with type 2 diabetes.
What is Tadalafil?
Tadalafil is a PDE5 inhibitor, a category of drugs that also includes Viagra.
These medications are typically prescribed to treat erectile dysfunction (ED).
Tadalafil, unlike other PDE5 inhibitors approved in Sweden, is long-acting and can be taken daily.
About the Study
The study involved 18 participants, 12 men and 6 postmenopausal women. The participants were randomly assigned to receive either a high daily dose (20 mg) of tadalafil or a placebo for six weeks.
After an eight-week break, they were switched to the other treatment for six weeks. The researchers monitored participants for side effects, as tadalafil has several known side effects.
Results and Findings
While the primary aim was to explore if tadalafil could enhance patients’ insulin sensitivity, no significant difference was observed compared with the placebo in this respect.
However, tadalafil did result in a notable improvement in metabolic control, as demonstrated by measurements of hemoglobin A1c (HbA1c) in blood samples.
On average, the HbA1c level dropped by 2.50 mmol/mol, an improvement similar to what has been observed with new drug candidates currently being considered as a fourth treatment option for type 2 diabetes.
HbA1c levels are closely monitored in patients undergoing treatment for type 2 diabetes. A high HbA1c value is linked to an increased risk of complications, such as microvascular damage to the eyes, kidneys, and nerves.
Conclusions and Future Implications
Tadalafil has the potential to supplement current treatment approaches for type 2 diabetes, especially in men who also suffer from ED – a condition affecting more than 70% of men with obesity and type 2 diabetes.
However, these preliminary findings need to be confirmed in larger, longer-term studies, which the University of Gothenburg research group is considering.
The main treatment for type 2 diabetes combines lifestyle changes with the drug metformin, but several new drugs have been developed over the past 10 to 20 years.
Tadalafil increases blood flow in skeletal muscle, the heart, and adipose tissue.
The current study also reported increased blood flow and a positive effect in the liver, where an established marker of fatty liver decreased during drug treatment compared to the placebo.
The researchers also observed an increase in glucose uptake during tadalafil treatment compared to the placebo.
However, it is crucial to stress that self-medication with PDE5 inhibitors should never occur, as it can be life-threatening when combined with certain other drugs.
These medications are only available via prescription and must always be prescribed by a healthcare provider.
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The study has been published in the journal eClinicalMedicine.
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