Diabetes is one of the most serious health problems of modern times. It is characterised by persistently high levels of blood glucose (sugar) in the body. At present, there is a whole range of effective medication for the treatment of Type 2 diabetes. Despite this, about 60 percent of populace diagnosed with Type 2 diabetes are not able to achieve good blood glucose control on their current treatment.
Recently discovered incretins (hormones that are secreted from enteroendocrine cells into the blood within minutes after eating) are Glucagon like peptide 1 (GLP1) which are impaired in Type 2 diabetes patients. Perhaps this may be a reason why patients with Type 2 diabetes are at increasing risk of abnormally high blood glucose levels. Uncontrolled diabetes leads to increased risk of developing serious long-term complications like heart disease, stroke, erectile dysfunction, kidney failure, blindness, foot amputation and conditions related to poor blood circulation. Some of the medications can possibly lead to hypoglycaemia (too low blood sugar), weight gain and gastrointestinal intolerance. Type 2 diabetes can also coexist with other high-risk conditions such as high blood pressure, abnormal lipids (high cholesterol) and obesity.
GLP-1 is secreted in the intestine and it helps the pancreas produce more insulin in response to the presence of high blood sugar. People with Type 2 diabetes are generally affected by other metabolic disorders like being overweight, having higher blood pressure and lipid levels. The ability of GLP-1 to help in weight loss, beneficial effects on blood pressure and lipids and its ability to protect the beta-cells — the insulin-producing cells in our pancreas — makes it an effective tool to control diabetes. Each individual’s diabetes is different and the appropriate treatment for each person can only be decided by his or her treating physician after a complete evaluation and taking into account various health parameters. Right medication plays a significant role in diabetes management. However, along with appropriate medicine, monitoring, healthy diet and regular exercise are necessary to control diabetes. Take smart decisions about what you eat, stay active, take your medications as advised by your doctor and you can enjoy a healthy and productive life.
In addition to this, GLP-1 works in multiple ways to keep Type 2 diabetes under control. It signals the pancreas to secrete more insulin when required, helps lower glucagon levels which stops the liver releasing unused sugar into the bloodstream, induces slower digestion to keep blood sugar levels from peaking in a short time interval after meals which translates into a reduced appetite and helps in preserving the number of insulin producing beta cells. Other key benefits are increased insulin sensitivity, weight loss and a beneficial impact on systolic blood pressure, lipid levels and heart function.
By Ganapathi B. and Arpandev Bhattacharyya
(Ganapathi B. is Professor of Endocrinology at St. John’s Medical College and Hospital, Bengaluru. Arpandev Bhattacharyya is a diabetologist with 26 years of medical experience. The views expressed are personal.)