The Benefits of Switching to a Non-Insulin Injectable
About a decade ago, the millions of us who have type 2 diabetes got a big break. This was when we got the first diabetes drug that offers a lot more than just keeping our blood glucose level down where it needs to be. As soon as it became available I jumped on it, and it changed my life.
These new drugs mimic the way that something our bodies naturally make called glucagon-like peptide-1 works. So most people call them GLP-1 agonists, except they last a lot longer. Our gut releases natural GLP-1 during digestion, reducing our blood glucose level. But it works for only a couple of minutes. The GLP-1 agonists overcome this problem.
GLP-1 agonists work only when you take them by injection because they are a protein that you stomach would digest. You take them in your stomach, your upper leg, or your upper arm, just like you would on insulin. Unlike fingerstick tests that we all need, shots in the stomach rarely if ever hurt. At first, you had to take two shots a day, but with newer GLP-1 agonists you need only one a week.
These non-insulin injectables stimulate the natural secretion of your body’s insulin, but only when your blood glucose level is high. This means that they won’t cause dangerous drops in blood glucose called “hypos,” like the way that insulin, and some other diabetes drugs do. That’s why some people call them smart drugs.
Your liver produces glucose, but you don’t need it after your meals. These non-insulin injectables stop your liver from making it when you don’t need it.
These non-insulin injectables restore the release of your body’s insulin in the first 10 minutes after you eat carbohydrates. When you have type 2 diabetes you generally lose this first-phase insulin response that you had before you got diabetes.
A new study indicates that a non-insulin injectable may be the only drug that can reverse a common and serious complication of diabetes, non-alcoholic steatohepatitis, or NASH. This is an inflammation of the liver that a buildup of fat there can cause.
These new diabetes drugs slow the digestion of your food. This allows the natural secretion of your body’s insulin and the delivery of the nutrients you eat to occur closer together. In turn, this leads to lower blood glucose levels after you eat.
They work on your central nervous system too. This reduces your appetite so you eat less. This means that unlike the other drugs for diabetes you can lose weight when you take one of these non-insulin injectables. My BMI went from 39.5 to 21.7 in less than two years. Insulin, all of the sulfonylureas, and several other diabetes drugs generally lead to weight gain and the others are weight neutral.
When you have type 2 diabetes, the beta cells that you have in your pancreas don’t make enough insulin to control your blood glucose. Animal studies indicate that these non-insulin injectables can reverse your diabetes by stimulating the birth of new beta cells, make more beta cells develop, and increase their mass. Test tube experiments indicate that they can prevent or slow the death of beta cells.