The pros and cons of new treatments for type 2 diabetes

Incretin is an intestinal peptide that helps regulate glucose metabolism by increasing insulin release. Since 2005, the US Food and Drug Administration has approved two new methods of drug development for the treatment of type 2 diabetic patients.

Sulfonylurea (SU) has been widely used since 1946 to treat type 2 diabetes. They lower blood sugar by stimulating the body's own pancreas to produce insulin. Because type 1 diabetic patients have lost the ability to produce insulin, these drugs are not suitable. Another widely used medicine is metformin. The use in the United States is temporarily interrupted due to concerns of side effects, but it has been widely used in Europe and Canada for 50 years. Metformin does not stimulate insulin, but it blocks gluconeogenesis. Since it does not increase insulin, this reduces the risk of hypoglycemia and weight gain

A simple model of primary hyperinsulinemia is insulin administration. People with type 1 diabetes who are not treated with insulin will lose weight no matter how much they ingest. In contrast, when insulin develops with overtreatment of type 2 diabetes or type 1 diabetes, weight may increase as expected. The essential part of this effect is metabolism, not just the difference in glucose loss in urine. In animals, insulin administration results in weight gain. Even if food intake is limited to prevent weight gain, animals become obese and insulin shows that metabolic fuel is redirected to fat of tissue at the expense of lean body mass. In addition, mouse transgenic experiments found that primary hyperinsulinemia decreased expression of uncoupling protein in white adipose tissue, increased energy expenditure, and protected animals from diet-induced obesity.

Treatment: Like type 1 diabetes, type 2 diabetes can not be cured. Obesity surgery can reduce type 2 diabetes, but this is not a cure. It can be managed in various ways, such as lifestyle measurement (weight loss, carbohydrate intake and physical activity management), injections other than diabetes medicine and insulin, insulin. Type 2 diabetes tends to change over time. This usually means more drugs that contain insulin to keep blood glucose levels safe