Dopamine agonist effects on hyperglycemia and the cardiometabolic profile

Dopamine plays a complex role in modulation of cardiometabolic parameters. Positive effects on glucose control and parameters of the metabolic syndrome have been demonstrated in both pre-clinical and clinical data. Pharmacologically, bromocriptine- quick release, a dopamine agonist used for treatment in type 2 diabetes mellitus, provides modest improvement in hemoglobin A1c (HbA1c), weight and lipids. Additionally, bromocriptine has a beneficial overall cardiovascular risk profile. The anti-hyperglycemic effects of bromocriptine are thought to be mediated through the circadian rhythm, but interesting research suggests that central dopamine action may underlie the beneficial cardiometabolic effects. This review will examine the pre-clinical and clinical data regarding known metabolic changes observed with dopamine agonist therapy. The role of prolactin, as a mediator of cardiometabolic risk or a signal of dopamine action, will be discussed