Can Tom Hanks Do What the CDC Has Struggled to Do for Type 2 Diabetes?


I don't know about you, but I seriously struggle to think of one bad movie that actor Tom Hanks has starred in. He's become one of the leading role-getters in Hollywood and expectations from movie studios are always high when they land the superstar.

Source: Wikimedia Commons.

That's why Monday's Late Night With David Letterman interview was expected to focus on Hanks' upcoming movie, Captain Phillips, and be the normal collection of small talk, film clips, and the typical joke or two.

But something very different happened. When Letterman commented on Hanks' "slimmer appearance," the actor elaborated a bit on his need to take better care of himself since he had recently been diagnosed with type 2 diabetes mellitus.

In the entertainment world, this revealing news was the equivalent of a bombshell. We often forget that behind the hundreds of millions of dollars in movie deals and fame that these are human beings who are susceptible to the same diseases we are.

Just this past May, Angelina Jolie took out an op-ed in The New York Times to inform the world that she had undergone double mastectomy in February as a precautionary measure since she tested positive for the BRCA gene mutation, which is known to have a higher propensity for causing breast and ovarian cancer in women. Jolie's mother passed away at 56 from breast cancer, so the actress wanted to do everything within her power to lower her risk of contracting the disease and ensure she'd be there to raise her kids.

Is Tom Hanks the spark we need?
What Tom Hanks' announcement and Angelina Jolie's brave act have in common is that they're helping raise awareness about serious diseases that otherwise might fly under the general public's radar.

For Hanks, he's certainly not alone. There are 25.3 million diabetics in this country and 79 million more peopleexhibiting pre-diabetic symptoms.

Source: Centers for Disease Control and Prevention.

Of those totals, about 90% of cases tend to be type 2 diabetes -- the form of the disease where your body produces insulin but it isn't used properly, which causes your blood glucose levels to rise well above safe levels. While hereditary factors do likely play into the make-up of type 2 diabetes, a lot of cases can also be traced back to a lack of proper diet, being overweight or obese, and a lack of physical activity. High blood sugar may not sound like a serious disease on the surface, but complications from long-term high-blood sugar can lead to heart attack, stroke, kidney failure, blindness, and lower-limb amputations .

To be perfectly honest, it's not as if the Centers for Disease Control and Prevention hasn't been doing its part by trying to make the public aware of type 2 diabetes. Unfortunately, far too few people have heeded the warning signs of this disease until it's too late.

Hanks' announcement of his own personal dealings with type 2 diabetes effectively breaks down the barriers between Hollywood and the average American dealing with this disease and potentially allows the actor to do what CDC hasn't been able to do before: put this disease front and center so at-risk people and current diabetics finally do something about it!

Dealing with diabetes
If you are shown to be pre-diabetic or to have type 2 diabetes, you'll be glad to know treatment drugs have vastly improved within the past couple of years, and that proper diet and regular exercise can go a long way to abating your symptoms.

Touching on some of the latest drugs and pipeline products to hit the market, perhaps none is more exciting than SGLT2 inhibitors such as Johnson & Johnson's Invokana, which is approved in the U.S., and Bristol-Myers Squibb and AstraZeneca's Forxiga, which is approved in Europe.

What makes this newest generation of type 2 diabetes drugs so intriguing is the pathway by which they work and their favorable safety profile compared to many previously approved diabetic treatments.

Few current treatments are known better than DPP-4 inhibitors like Merck's Januvia, which works out of the liver and the pancreas by increasing incretin levels that inhibit the release of glucagon and ultimately bring about glycemic balance by causing a user's blood sugar to drop. Unfortunately, DPP-4 inhibitors also have a questionable long-term-safety profile that can include pancreatitis, kidney problems, and, in rare cases, severe allergic reactions.

On the other side, we have SGLT2 inhibitors, which work in the kidneys instead of the pancreas and liver. These drugs work by blocking glucose absorption via the sodium glucose co-transport inhibitor 2, allowing for excess glucose to be flushed out through a patient's urine in order to achieve proper glycemic balance. To add, SGLT2 inhibitors like J&J's Invokana and Bristol-Myers and AstraZeneca's Forxiga also delivered the welcome side effect of weight loss in clinical trials relative to DPP-4 inhibitors, which are weight neutral, and pre-DPP-4 diabetes drugs, which often led to weight gain. Being overweight or obese only exacerbates diabetes symptoms, and while these drugs may not be indicated for weight loss, they're certainly pushing patients in the proper direction.

Another interesting name we may be hearing about a few years down the road is Lexicon Pharmaceuticals , which is developing an early-stage drug known in-house as LX4211. This particular type 2 diabetes drug targets both the SGLT1 and SGLT2 co-transporters and could add an even greater effect in terms of weight loss and quicker postprandial (after a meal) glucose reduction. In a recent proof-of-concept study, Lexicon's LX4211 delivered increased levels of GLP-1 production, a hormone responsible for controlling glucose levels and our appetite, as well as reduced post-prandial glucose levels. It could possibly be the next-generation type 2 diabetes drug, though it's still very early in the clinical trial process.

Breaking down barriers
Tom Hanks has certainly never been one to shy away from the spotlight and his recent admission of having type 2 diabetes is no exception. Sometimes we need that jolt from a popular figure in society to wake us up and make us realize we're all human and susceptible to disease; yet we also have a lot of abilities within ourselves based on how eat and exercise to control many of the factors that can lead to those diseases. Furthermore, Hanks is showing that even if you contract type 2 diabetes it isn't the end of the world. Proper diet and exercise -- as well as rapid improvements in the aforementioned next-generation type 2 diabetes drugs, which could dominate over the next five years -- should be able to help most sufferers lead a perfectly normal life.

Following Angelina Jolie's brave move, there was a defined improvement in the number of women who said they were planning on getting a gene test to determine if they, too, carried the BRCA gene mutation. Might pre-diabetic and diabetic patients consider more preventative measures and trips to the doctor to better manage their disease with a publicly loved figure like Hanks stepping out of the shadows and into the spotlight? Only time holds the answer to that question, but my magic-8 ball is reading a loud and clear, "Yes!"

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