Reversal of Type 1 Diabetes by Engineering a Glucose Sensor in Skeletal Muscle

  1. Alex Mas12,
  2. Joel Montané12,
  3. Xavier M. Anguela12,
  4. Sergio Muñoz12,
  5. Anne M. Douar3,
  6. Efren Riu12,
  7. Pedro Otaegui12 and
  8. Fatima Bosch12
  1. 1Center of Animal Biotechnology and Gene Therapy, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
  2. 2Department of Biochemistry and Molecular Biology, School of Veterinary Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
  3. 3Généthon III, Evry, France
  1. Address correspondence and reprint requests to Fatima Bosch, Center of Animal BiotechnologyGene Therapy, School of Veterinary Medicine, Universitat Autònoma de Barcelona, E-08193-Bellaterra, Spain. E-mail:{at}


Type 1 diabetic patients develop severe secondary complications because insulin treatment does not guarantee normoglycemia. Thus, efficient regulation of glucose homeostasis is a major challenge in diabetes therapy. Skeletal muscle is the most important tissue for glucose disposal after a meal. However, the lack of insulin during diabetes impairs glucose uptake. To increase glucose removal from blood, skeletal muscle of transgenic mice was engineered both to produce basal levels of insulin and to express the liver enzyme glucokinase. After streptozotozin (STZ) administration of double-transgenic mice, a synergic action in skeletal muscle between the insulin produced and the increased glucose phosphorylation by glucokinase was established, preventing hyperglycemia and metabolic alterations. These findings suggested that insulin and glucokinase might be expressed in skeletal muscle, using adeno-associated viral 1 (AAV1) vectors as a new gene therapy approach for diabetes. AAV1-Ins+GK–treated diabetic mice restored and maintained normoglycemia in fed and fasted conditions for >4 months after STZ administration. Furthermore, these mice showed normalization of metabolic parameters, glucose tolerance, and food and fluid intake. Therefore, the joint action of basal insulin production and glucokinase activity may generate a “glucose sensor” in skeletal muscle that allows proper regulation of glycemia in diabetic animals and thus prevents secondary complications.


  • A.M. and J.M. contributed equally to this work.

    DOI: 10.2337/db05-1615

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted March 9, 2006.
    • Received December 14, 2005.
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