What is GPL-1 (Glucagon like peptide -1 )
Type 2 Diabetes is a complex game with many players.
Most of us are aware of Beta cell dysfunction and failure causing insulin deficiency and we are familier with the term insulin resistance and its association with weight gain and obesity.
We are less familier with the dysfunction of the pancreatic alpha cells and inappropriate Glucagon release triggering the liver to release glucose resulting in higher fasting and after meal glucose levels
The , newest member of this group , is a deficiency of a hormone made in our intestine, Glucagon like Peptide -1 (GPL-1 ).
This hormone is released in response to eating and has a powerful influence on our ability to manage blood glucose levels.
Effects of GPL-1
#1 Glucose - Dependent insulin secretion. This hormone allows insulin secreting Beta Cells to
produce insulin in response to an increase in glucose levels.
#2 Decreases glucagon levels resulting in lower fasting and after meal glucose levels
#3 Appetite suppression and Slows gastric emptying
Products Available to replace GLP-1 deficiency
Exenatide ( Byetta ) a twice daily injection
Liraglutide ( Victoza ) one injection per day
Exenatide ( Bydureon ) weekly injection
GLP1 agonist DPP4 inhibitors acarbose Insulin sulfonylureas
Effectively reduce A1c YES YES YES YES YES
Preserve Beta cell function YES ? NO NO NO
Promotes weight loss YES No + - NO NO
Promotes weight gain NO NO + - YES YES
Do not cause hypoglycemia YES YES YES NO NO
Once a week injection YES NO NO NO NO
Glucagon suppression YES YES NO NO NO
Most expensive YES +- NO + - NO
Tomorrow I will review DPP-4 inhibitors.
Have Fun , Be Smart and take advantage of the wonderful new medications available for treating type 2 diabetes