FILIP KRAG KNOP: "A HUGE HONOUR TO RECEIVE THE MINKOWSKI PRIZE"

Clinical professor, consultant physician and research director Filip Krag Knop of Herlev-Gentofte Hospital and Steno Diabetes Center Copenhagen (SDCC) today received the prestigious Minkowski Prize at the EASD European diabetes congress in Barcelona for work including his clinical research on the hormone glucagon.

Since the Minkowski Prize was first awarded in 1966, only three Danes have received this distinguished honour: J. Nerup, in 1978, Thomas Mandrup-Poulsen, in 1994 and Professor Peter Rossing, in 2005. As of today, though, Denmark can boast that another of the country’s professors has won the prize. Earlier today, clinical professor, consultant physician and research director Filip Krag Knop of Herlev-Gentofte Hospital and SDCC was presented with the Minkowski Prize in a ceremony at the EASD meeting currently under way in Barcelona.

‘It is a truly great honour to receive this prize – one of the biggest things to have happened to me in my career. And I did have a touch of the jitters when I was told, just before the summer, that I was to receive this distinguished prize. After all, I see from the list of previous recipients that I will be in alarmingly good company’, says Filip Krag Knop.

The prize, which is awarded for outstanding contributions to the advancement of knowledge in the field of diabetes, goes to Filip Krag Knop for work including his research on the hormone glucagon.

‘A lot of attention has been focused on the fact that patients with type 2 diabetes secrete too little insulin. But these patients are also characterized by overproduction of glucagon. This has actually been well known for a long time, but the cause was not known, and this is one of the things we were interested in’, says Filip Krag Knop.

Just as it is important for the body to produce insulin, which ensures that the blood sugar level can be reduced, it is also important for the body to have mechanisms that can make blood sugar go up. Glucagon has this property.

‘It used to be thought that glucagon was produced only in the pancreas, but we now know that this is not the case. One way we know this is that we can see that people without a pancreas still produce the hormone. And what we have found and demonstrated is that a high glucagon level in diabetes patients – especially after food intake – is due to the hormone also being produced in the gut’, says Filip Krag Knop.

Two explanations for high glucagon level
The presentation given by the Danish professor at EASD today concerned a number of scientific discoveries that provide two completely new explanations as to how circulating glucagon levels can be too high in diabetes patients. One explanation is based on Filip Krag Knop’s discovery that the gut secretes large quantities of glucagon in response to meal intake, thus explaining patients’ paradoxically high glucagon levels after intake of carbohydrate, for example. A number of other discoveries by Filip Krag Knop’s research group explain why the fasting glucagon level can be elevated in overweight type 2 diabetes patients. This was hitherto thought to be a diabetes phenomenon involving faulty glucagon-producing cells in the pancreas, but Filip Krag Knop’s results show that it has more to do with excess weight and fat accumulation in the liver.

‘Our results have helped to reveal a completely new physiological axis between the liver and the pancreas, one that can be damaged as a consequence of excess calories and resultant fat accumulation in the liver. Our findings also do away with a lot of old dogmas. We hope our results will lead to new treatments or the development of new treatment goals in the future’, says Filip Krag Knop.

The Hippocratic oath as a guide
And the therapeutic perspective is the crucial thing for Filip Krag Knop, who, as a clinician, also works with diabetes patients in the clinical setting. With the Hippocratic oath as a guide in his practice, working to improve patients’ treatment and prognosis is important to him.

‘The combination of the Hippocratic oath and a fundamental curiosity about what is going on physiologically when people get ill is what drives me. I am deeply fascinated by what I as a scientist have in common with the researchers of ages past on whose shoulders I stand. They are my idols, and they also become virtual collaborators when you pick up their earlier research and carry on with it from where they left off. Meanwhile, as a clinician I can look to my Hippocratic oath and try to translate that research into something of practical use to patients’, says Filip Krag Knop.