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Glucagon-like peptide-1 (GLP-1) is a hormone that plays a critical role in glucose metabolism. It is secreted by the intestines in response to food intake and helps to lower blood glucose levels by stimulating insulin secretion from the pancreas. In addition, GLP-1 slows gastric emptying, reducing the rate at which glucose enters the bloodstream. Given its crucial role in glucose regulation, both natural and synthetic GLP-1 have been studied for their potential impact on glucose control.
Prescription GLP-1 receptor agonists, such as exenatide and liraglutide, have been used as therapeutic agents for type 2 diabetes. These drugs mimic the action of natural GLP-1 but are resistant to degradation by an enzyme called dipeptidyl peptidase-4 (DPP-4), allowing them to have longer-lasting effects. Multiple clinical trials have shown that these medications can significantly reduce Hemoglobin A1c (HbA1c) levels, a marker of long-term blood glucose control, in people with type 2 diabetes.
These prescription drugs also promote weight loss, which can further improve glycemic control in overweight or obese individuals with type 2 diabetes. However, they can cause side effects such as nausea and vomiting due to their effect on gastric emptying.
On the other hand, natural GLP-1 is produced endogenously by our bodies and has similar effects on insulin secretion and gastric emptying. However, it is rapidly degraded by DPP-4 enzymes, limiting its effectiveness in controlling blood glucose levels over time.
To enhance the action of natural GLP-1, researchers have explored using DPP-4 inhibitors such as sitagliptin and vildagliptin. These medications block the degradation of endogenous GLP-1, thereby increasing its levels and prolonging its action. Clinical trials have shown that DPP-4 inhibitors can also reduce HbA1c levels in people with type 2 diabetes, although their effects on weight are less pronounced than GLP-1 receptor agonists.
In conclusion, both prescription and natural GLP-1 have significant impacts on glucose control. Prescription GLP-1 receptor agonists provide robust glycemic control and promote weight loss but may cause gastrointestinal side effects. Meanwhile, enhancing the action of natural GLP-1 using DPP-4 inhibitors offers another effective strategy for glucose control with a different side effect profile. The choice between these therapies should be individualized based on the patient’s specific needs and tolerance.