Concentrated broccoli sprout extract may help type 2 diabetes patients manage their blood sugar, according to a new study. The findings could offer a much needed alternative to address the condition, which has become a worldwide epidemic.

Type 2 diabetes afflicts more than 300 million people globally, and as many as 15% of those patients cannot take the first-line therapy metformin because of kidney damage risks. Seeking a more viable path forward, researchers used a computational approach to identify compounds that might counter the disease-associated gene expression changes associated with type 2 diabetes.

The researchers constructed a signature for type 2 diabetes based on 50 genes, then used publically available expression datasets to screen 3,852 compounds for drugs that potentially reverse disease. The most promising chemical -- sulforaphane, a naturally occurring compound found in cruciferous vegetables -- tamped down glucose production by liver cells growing in culture, and shifted liver gene expression away from a diseased state in diabetic rats.

Authors show that sulforaphane suppressed glucose production from hepatic cells by nuclear translocation of nuclear factor erythroid 2–related factor 2 (NRF2) and decreased expression of key enzymes in gluconeogenesis. Moreover, sulforaphane reversed the disease signature in the livers from diabetic animals and attenuated exaggerated glucose production and glucose intolerance by a magnitude similar to that of metformin.

When the researchers gave sulforaphane, concentrated in broccoli sprout extracts,  to 97 human type 2 diabetes patients in a 12-week randomized placebo-controlled trial, obese participants who entered the study with dysregulated disease demonstrated significantly decreased fasting blood glucose levels compared to controls.

The authors say developing gene signatures to investigate large public repositories of gene expression data could be a valuable strategy to rapidly identify clinically relevant compounds.

http://stm.sciencemag.org/content/9/394/eaah4477