Saturday, April 4, 2015

The Nutrition Debate #302: Another pill to prevent Type 2 Diabetes?

As everyone who regularly reads this blog knows, I am not a pill pusher. I once was a big-time pill-taker, however, until I tried an alternative “treatment plan” for my Type 2 diabetes. I was a passive victim of “the current treatment protocols (that) trap patients in a lifelong regimen of drug management, obesity and escalating diabetes” (see #292 here). 

That stopped when my doctor “prescribed” a total change of diet, to lose weight,which had the added effect of putting my diabetes in clinical remission. I went from being maxed out on 2 oral diabetes meds and starting a 3rd (with an out of control FBG) to where I am today, taking 1 low-dose Metformin and good glucose control. My A1c’s are always in the 5s.

But this blog is not about Very Low Carb dieting. It is about an interesting new idea (for me) from some Danish researchers, according to this Diabetes in Control story. It is based on “a large study population of adults (lean and obese, men and women) with normal and impaired glucose regulation.” They are from the Steno Diabetes Center, a Danish hospital and research organization owned by the drug maker Novo-Nordisk, “working in partnership with the Danish healthcare system.”

The FINDING, which could prove to be significant: “Reduction in the glucose-regulating hormone glucogon-like-peptide-1 (GLP-1) appears to occur before the development of type 2 diabetes and obesity," according to the abstract in Diabetes.

The lead investigator told Diabetes in Control, “We found that GLP-1 is reduced by up to 25% among people with pre-diabetes and up to 20% among obese people compared to normal-weight people. This indicates that the reduction in GLP-1 is not a consequence of type 2 diabetes, but appears much earlier in the disease development and may predispose people to type 2 diabetes.” These results were all in response to an oral glucose tolerance test (OGTT).

The Diabetes in Control piece also noted, “And what is surprising is that they have also found pronounced differences in GLP-1 secretion between men and women. They observed a higher GLP-1 response among women than men, but when glucose tolerance worsens, the decline in GLP-1 secretion is more pronounced in women than in men.”

Of course, as might be expected from a hospital research department “owned by Novo Nordisk, working in partnership with the Danish healthcare system,” the researchers casually said, “‘These results could have potential clinical implications as well,’ noting that GLP-1 analogs may help delay onset of type 2 diabetes,” Diabetes in Control noted. A GLP-1 analog would be a new drug designed “to prevent diabetes for those with prediabetes.” And…for overweight and obese patients too?

They may be on to something here. Preventing the destruction of GLP-1 would be a worthy area for further investigation. But, alternatively, developing a new drug, a GLP-1 analog, to treat the symptom rather than the cause – something that Big Pharma, working in partnership with the…healthcare system (government funding) does so well – is a sure fire hit. It sounds like a big money maker (for Novo Nordisk) to me. Think statins, or blood pressure medications, or any other of “the current treatment protocols (that) trap patients in a lifelong regimen of drug management.”

Hey, I believe in capitalism, and Novo Nordisk is not an eleemosynary enterprise. They have a pecuniary interest in this research. So, let’s hope the researchers are sincere when they say, according to their press release, “We should use the findings in prevention strategies for type 2 diabetes.” Sounds good. More studies. In the meantime, eat Very Low Carb! Preserve your GLP-1!

5 comments:

  1. Sounds like another way to let people think they can continue eating what they want if they just take a pill. And, since the damage won't show up for maybe 10-20 years anyway, who is to say it's not working? We "consumers" are so gullible. Just give us a pill to take with our donuts.

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    1. I agree, of course, but I now have a somewhat different impression. Before I tell you about it, though, I think the idea that a precursor to type 2 is depletion of GLP-1 is novel. The research heretofore has been focussed on IR, and this is, I think, a different track and might prove fruitful. In any case, while Big Pharma works on a GLP-1 analog to 'treat' the deficit, others will no doubt work on the mechanism for why the deficit occurs in the first place, and that could lead to something, hopefully.

      At the 'we consumers' being gullible, it still baffles me why we seem to ignore what is in our best interest, including the reasons you give that we don't feel sick and the damage won't show up for maybe 10-20 years' etc. I have also just finished reading Eric Topol's 'The Patient Will See You Now," and he, an MD, talks a lot about Paternalism in medicine and how the profession uses that attitude, and resists change like letting patients own their own medical records, to preserve their status as gods. We, the consumers, in turn allow it because we don't want to take responsibility for and accept our part in preserving and improving our health. It's so hard to quantify, but I and many who follow our WOE know that we feel better generally when we avoid excess fructose, wheat and vegetable oils, etc.

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  2. They already have a GLP-1 analog called Victoza. I am on it and is just one molecule different from the real hormone so it isn't broken down by another hormone our body has.

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    1. I know. I was for 10 years an investor in Amylin, the original developer of Byeta, the original GLP-1 analog. I guess I wasn't clear in #302. The interesting thing about this abstract or digest is that they think the GLP-1 deficit precedes Insulin Resistance and may be causitive. Therefore, treating the deficit, before T2DM fully develops, is what they propose. My cynicism, which interfered with my message, was that they should instead be seeking to understand the cause of the deficit rather than treating the effect. But then, they wouldn't have another drug to peddle.Thanks for commenting, though, and I'm glad Victoza is working for you. It's a good drug, I think, and a valued step in the treatment of progressive T2DM (before becoming insulin dependent) if you are unable to treat this dietary disease by self-management of what you and your family eat.

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