Can you explain the role of insulin and other medications in the treatment of diabetes?

Question

Dr. Anna Goldman, MD · Answer

So, can you explain the role of insulin and other medications in the treatment of diabetes? Yes. So what is insulin? It's a hormone made by the beta cells in the pancreas, arise in sugar or glucose is the stimulus for insulin release. Insulin is what we call an anabolic hormone and that it helps the body to turn the carbohydrates from the food that we eat into energy. And so, it does this by stimulating glucose, uptake into fat and muscle and storing excess glucose as something called glycogen in the liver that can be used. For energy in the fasting State, people who have type 1, diabetes are insulin deficient and generally have to start taking insulin as soon as they're diagnosed. Although this is not always the case with type 2 diabetes. These patients generally have insulin resistance such that their bodies are not responding appropriately to insulin. Sometimes these patients do need to go on insulin, but generally I prefer to try non-insulin agents first. That may also have other non glycemic benefits as well. So sulfonylureas are pills that Are effectively like taking insulin, but they just cause one's own body to release more endogenous insulin. They do lose efficacy over time and have a risk of hypoglycemia or low blood sugar levels and they can also lead to weight gain. Metformin, is a very effective medicine which works by inhibiting gluconeogenesis. Meaning it lowers blood sugar levels by preventing the liver from inappropriately. Making new glucose patients often lose weight and the risk of hypoglycemia is really low. So it's Generally one of the first medicines, we try the glp-1 receptor Agonist take advantage of something called the in curtain effect which is mediated by hormones made in the gut in response to the ingestion of food so they're very effective at preventing postprandial. Post, eating blood glucose Rises and they often lead to weight loss. And then finally, the sglt2 Inhibitors are medicines that cause the kidneys to excrete more glucose in the urine. And so they're also very effective. Thanks.

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"Can you explain the role of insulin and other medications in the treatment of diabetes?"