The Benefits of Switching to a Non-Insulin Injectable
David Mendosa | Dec 2, 2015 Nov 21, 2016
Reviewed by Robert Hurd, MD
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.
How these drugs work
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.
One non-insulin injection a week
GLP-1 agonists work only when you take them by injection because they are a protein that your 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.
They are 'smart drugs' that produce insulin only when you need it
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.”
They also stop your liver from making too much glucose
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.
They restore first-phase insulin response
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 the first-phase insulin response that you had before you got diabetes.
They can reverse liver disease
A 2015 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.
Slower digestion means lower blood glucose, with some side effects
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.
Like any medications, these GLP-1 agonists have their own side effects, including some nausea, as well as some more serious type of abdominal pain called “pancreatitis.” The long-acting GLP-1 agonists cause less nausea than the short-acting ones.
They can reduce your appetite and weight
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 body mass index 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.
They restore normal beta cell function
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.