Clinical investigation of glucokinase activators for the restoration of glucose homeostasis in diabetes

J Diabetes. 2024 May;16(5):e13544. doi: 10.1111/1753-0407.13544.

Abstract

As a sensor, glucokinase (GK) controls glucose homeostasis, which progressively declines in patients with diabetes. GK maintains the equilibrium of glucose levels and regulates the homeostatic system set points. Endocrine and hepatic cells can both respond to glucose cooperatively when GK is activated. GK has been under study as a therapeutic target for decades due to the possibility that cellular GK expression and function can be recovered, hence restoring glucose homeostasis in patients with type 2 diabetes. Five therapeutic compounds targeting GK are being investigated globally at the moment. They all have distinctive molecular structures and have been clinically shown to have strong antihyperglycemia effects. The mechanics, classification, and clinical development of GK activators are illustrated in this review. With the recent approval and marketing of the first GK activator (GKA), dorzagliatin, GKA's critical role in treating glucose homeostasis disorder and its long-term benefits in diabetes will eventually become clear.

Keywords: dorzagliatin; glucokinase; glucose homeostasis; type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Animals
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Enzyme Activators / pharmacology
  • Enzyme Activators / therapeutic use
  • Glucokinase* / metabolism
  • Glucose / metabolism
  • Homeostasis*
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use

Substances

  • Glucokinase
  • Enzyme Activators
  • Hypoglycemic Agents
  • Blood Glucose
  • Glucose