Incretin Drugs and Type 2 Diabetes

incretin drugs

 

 

 

 

 

 

Among the prescription drugs that are used to “treat” type 2 diabetes are a class known as incretin drugs.  I am using “treat” in quotations for a good reason here, drugs don’t actually treat diabetes and these ones sure don’t, they do treat high blood sugar for a time until they end up failing to do so, but the problem with diabetes is that we look at the disease as one of high blood sugar when this is clearly not the case.

Type 2 diabetes is manfest by a number of hormonal imbalances, hormonal excesses actually, for instance too much insulin, too much glucagon, too much leptin, too much cortisol, too much amylin, and so on.

Our approach to treating diabetes is centered around making these hormonal excesses intentionally worse, and in doing so, we can lower blood sugar for a time, but it’s always on borrowed time, as these excesses are what is behind the disease itself, so as you worsen them, you worsen the underlying condition.

Insulin excess and the resulting insulin resistance is a good example of how this story ends up playing out.  We know that diabetes is caused by too high levels of insulin over time, and it’s widely thought that this is due to increasing insulin resistance, and that’s sort of what goes on, but what really happens is that this toxic load of insulin ends up poisoning our cells, including the alpha cells of the pancreas which secrete glucagon.

So over time, glucagon levels rise as well, and this causes insulin levels to go up even more, which further damage the alpha cells, which causes even more glucagon to be released.  As glucagon rises, so does blood sugar, and in the end it goes up enough that one gets diagnosed with diabetes.

So do you think the solution here is for us to increase insulin even more, on purpose, leading to more cellular damage and higher levels of glucagon over time?  Well that’s exactly what we like to do.

The goal, instead, needs to be to restore hormonal balance, to lower levels of insulin and other hormones that are in excess with type 2 diabetes, but we do the opposite.

People assume that because our blood sugar is too high, and insulin lowers blood sugar, our insulin levels are too low, but when we measure them we clearly see that this is false, that our insulin levels, the area under the curve, the amount of insulin we are exposed to on a daily basis, is significantly higher than non diabetics.

We also tend to assume that other things are too low when they are in fact too high, and this is the case with the incretin hormones, GIP and GLP-1.  So we have a class of medication which increases these hormones, either by injecting a synthetic version of GLP-1 or by taking an oral medication that increases the level of both hormones by preventing their degradation, the DPP-4 inhibitors.

I’ve read that it is suspected that type 2 diabetics are low in both these hormones, and you would think that anyone making such a claim would take the time to measure them in diabetics and then compare with the levels of non diabetics to see, and this is not difficult to do, and can be done with standard oral glucose tolerance tests, the kind we give type 2 diabetics quite often anyway.

We don’t even bother to measure insulin when we do this, we just assume it’s too low because our blood sugar is too high, and we also assume that the incretin hormones are too low for the same reason.

If they are instead too high, well we know that it’s unhealthy for any hormone to be too high, and we also know that these hormones both stimulate insulin release.  We also know that, being diabetic, our beta cells undersecrete insulin in response to glucose sensing, because they are damaged.  So why are our insulin levels too high, shouldn’t they be too low?

Well this is probably due to incretin hormones, and if they ran too high, this would explain the discrepancy.  There really isn’t even another good candidate for this.  Excess GIP not only increases insulin secretion, it also increases glucagon secretion, another hormone that is too high with us and the direct cause of high blood sugar.

So how much GIP and GLP-1 do we secrete anyway?  Well someone decided to actually check this, what a concept, actually test the levels to settle the argument.  Here’s what they found, and I invite you to click on this link to the chart if you wish and view it for yourself, because it does tell a real story.

So we see three types here, normal, impaired glucose tolerance, and diabetic.  When we compare them, we see glucose elevated in diabetics, which would have been an easy one to guess, insulin levels, the area under the curve in particular, elevated as well, and look at that, both incretin hormones are elevated as well, and very significantly as well.

There goes the idea that we are low in any of this, we are too high.  So what do you think will happen if we raise the levels of incretin hormones further, as incretin drugs do?

Well this will indeed bring down your blood sugar at first, as insulin would, and for the same reason basically, incretins raise insulin and insulin increases peripheral uptake of glucose, it takes some of this excess glucose and rams it into cells whether they want it or not, and they do not, but this overwhelms their ability to fight back, for now.

What else does this do?  Well when you raise insulin even further, you end up damaging alpha cells even more, resulting in their being even more deaf to glucose, and leading to even more excessive glucagon secretion.  We see them pumping out lots and lots of glucagon even in cases where blood sugar is extremely high, because they are so damaged from insulin excess that they cannot tell, so making this worse is a bad idea indeed.

Raising these incretin hormones have other effects on the body besides raising insulin though, for instance they cause tumors in the pancreas, and this isn’t a rare side effect, they did an autopsy on a number of patients who died and were on these medications, and found pancreatic tumors in every single patient, even those who were only on the drugs a short time.

Now these tumors weren’t cancerous, yet, but does anyone think it’s a good idea to promote tumor growth in the pancreases of diabetics?  Does anyone think that causing islet cells to mutate such that we see ones that are both alpha and beta, something we would want?

In spite of these so called side effects of these medications, which may even take your life, it’s not even the side effects we need to worry about as much as the main effect, just another way to worsen our hormonal imbalances and purposely progress our disease.  There’s the wonders of modern medicine at work for you.

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