Dr. Rachel Bedard

Insulin helps your muscles take the glucose out of your blood into the muscle and use it for energy.

What happens in people of type 2 diabetes or people of prediabetes is they develop insulin resistance, which means that they have decreased response to insulin, which means they are less effective at taking the glucose out of your blood.

And that means that your body needs to release more insulin in order to take that glucose out of your blood.

Yeah.

So for diabetics...

who often have very high levels of glucose just like circulating in the blood.

High levels of glucose is called hyperglycemia.

It has all sorts of downstream effects.

It hurts your eyes, it hurts your kidneys.

Eventually, it contributes to plaque buildup in your arteries, which can cause heart attacks and strokes.

So what you want to do in diabetics is get their glucose levels, their average circulating glucose levels down.

And GLP-1 agonists help do that by signaling to your pancreas when you have a glucose spike to release insulin so that the glucose spike doesn't spike too high.

Basically, it helps sort of maintain your glucose levels within a range that your body can handle.

And GLP-1 agonists, through that sort of combination of effects, the semaglutide, like, wugoviozempics, lead to, like, 10 to 15% body weight loss over the course of a year in the studies.

But the thing that I think is really interesting about these drugs, and one of the reasons that they've inspired so much excitement, is because they've had effects that we sort of anticipated that were, like, targeted effects in the initial trials.

improved blood sugar control and weight loss.

And then they've had a bunch of unexpected downstream effects probably related to weight loss and better blood sugar control, like they prevent heart attacks, they prevent strokes, they prevent people from progressing to diabetic kidney disease.

They seem to improve people's knee arthritis, which, like, was really unexpected.

They seem to improve heart failure.

And then they also have this potential effect around addiction.