Dr. Hilkovitz shares how hyperglycemic (high blood sugar) drugs work.
They work in several different ways. You’ve got metformin that tells the liver not to make so much sugar during the night, you’ve got the sulphonylureas which stimulate the pancreas to release more insulin, you’ve got insulin itself which puts the sugar into the muscles that use it and the cells that need it, you’ve got the insulin sensitizers like pioglitazone and rosiglitazone which help the muscle to use insulin better and glucose better. Unfortunately, they put weight on people, so there’s a limited use for them.
We also have the new Incretin hormones which are the intestinal hormones that tell us when we’re satisfied, when we need to stop eating. They also regulate our blood sugars and they tell our brains, "Time to stop eating." They also slow down stomach emptying. Now we have those naturally, but they don’t last in our bodies long enough to be effective because they’re destroyed by an enzyme called DPP-4.
Now a new drug Januvia inhibits that destruction. It inhibits DPP-4, and so our own intestinal hormones last longer and are able to help the sugar down.
About Dr. Hilkovitz, M.D., B.Ch.:
Dr. Gabriel Hilkovitz has been in private practice for 51 years working in internal medicine, primary care, with an emphasis in diabetes and works in connection with the Arizona Heart Institute. He is a former Professor of Medicine at the Medical College of Virginia. Dr. Hilkovitz was born and educated in South Africa and also engaged in academia in London, England and the United States.
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