The present invention relates to a modulator of the Smoothened (Smo) receptor capable of altering cellular glucose uptake for use in the treatment of a disease, wherein (a) the modulator is an activator of the Smoothened (Smo) receptor capable of increasing cellular glucose uptake and is for use in the treatment of diabetes, glucose intolerance, hyperglycemia, obesity, overweight, sepsis and diseases associated therewith or (b) wherein the modulator is an inhibitor of the Smoothened (Smo) receptor capable of decreasing cellular glucose uptake and is for use in the treatment of hypoglycaemia. Further, the invention relates to a method of altering the glucose uptake, the lactate level, the NAD+/NADH ratio and/or the NADP+/NADPH ratio of a cell and a method of identifying a modulator of the Smoothened (Smo) receptor capable of altering the glucose uptake, the lactate level, the NAD+/NADH ratio and/or the NADP+/NADPH ratio of a cell. Also, the invention relates to a method of increasing uptake of glucose or a glucose analogue labelled with a detectable moiety.
