Dr. Ben Bikman

originally used these glp-1 activators worked actually by inhibiting glucagon so back to the alpha cell that i mentioned earlier it's we come back to them now where in type 2 diabetes the insulin resistance of the alpha cell results in a chronic elevation of glucagon chronically then telling the liver to be releasing glucose leading to the hyperglycemia that defines the diabetic state

at this low dose semaglutide inhibits the alpha cell it inhibits glucagon and by inhibiting glucagon you're helping correct blood glucose so it was an effective anti-diabetic

Now, some people have the very mistaken view that semaglutide or GLP-1 activators also release insulin.

That is not true.

That has been shown to happen in isolated cell cultures, but in humans, there's no evidence.

And the authority on the subject is a guy named Arne, A-R-N-E, Ostrup, A-S-T-R-U-P, Arne Ostrup in Denmark.

He's one of the absolute authorities on this topic.

He's published multiple papers in humans showing that no amount of GLP-1 elicits an insulin release.

So we need to put that idea to bed.

In humans, that does not happen.

GLP-1 does not act as what's called an insulin secretagogue or a drug that forces the beta cell to make insulin.

glp-1 inhibits glucagon which helps correct blood glucose now as the dose starts to go up higher just i guess just for the sake of time i'd mention two effects which is one in the guts and then one central within the intestines glp-1 will act to delay gastric emptying and slow peristalsis so that has the effect of a person eating

and having that bulk sit in their stomach much longer, which is going to generally discourage them from wanting to eat more.

At the same time, it's gonna take a lot longer to get through the intestines.

Now, that is good for weight loss because it forces them to eat less,

A consequence of that is it ranges from the uncomfortable to the problematic.

So on the uncomfortable side, the person will have food that's sitting in their stomach for up to 20 hours.

And so they will start burping a lot and they will have like people who go through general surgery and have to be put under for general anesthesia.

they found that normally you tell the person don't eat for 24 hours and their stomach's empty, so they're not going to vomit food up while they're asleep.

But when they found that if people were on semaglutide, the food was still there and they would still have food in their stomach even though they hadn't eaten for 24 hours.