VIDEO: Important to carefully weigh benefits, risks of different diabetes medications

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So these are no longer new medications. I was one of the first people ever, back in the late '80s, to give this GLP-1. One of my colleagues named Joel Habener had basically discovered the active principle of the GLPs. These are proteins, by the way, polypeptides that we make ourselves in the intestine. And what they did was they isolated the active component and figured out how to synthesize it. And I was, back in the late '80s, starting to give it to volunteers and human research. And the first thing that happens, we wanted to demonstrate in both nondiabetics and people with diabetes, type 2 diabetes, that if you gave the drug, that it increased insulin and lowered glucose. And we showed that. The second thing that we noticed, that when we increased the rate, people would lean over the side of the bed and throw up. And so the side effect of the slowing gastric motility, the emptying of the stomach, and affecting the satiety center maybe in the brain, which is what it's being used widely for now, for weight loss, independent of diabetes. You know, we saw that many years ago. So now we fast-forward, and the pharmaceutical industry has cleverly first developed injections. And now these GLP-1 receptor agonists, and there are about four or five of them that are approved, are now being combined with other naturally occurring gut peptides to even increase the rate. Because it turns out that this is, if you think about it, when you eat a meal, something, there have to be signals to tell your pancreas to wake up, to start synthesizing insulin. These were called incretins. And now we're in the stage where we're getting, you know, the newer ones are a little bit better than the older ones now that the principle has been established. And the new combinations of several of these drugs mixed into one is kind of the next step in terms of that. There's already one called tirzepatide, which is a combination of a GIP and a GLP. And sure enough, you know, it is even, I think is substantially better than the old GLPs. The weight loss is greater, the insulin secretion is better. There are lots of other insulins. New insulins continue to be developed, longer-acting insulins, I mean, very long, weekly insulins that could be given once a week. And on the other side, even more rapid insulins that act more physiologically. Those are largely beneficial, in my opinion, more for the type 1 population, actually, than for the type 2. Having an insulin injection that you give once a week has been actually developed, a drug called icodec, which was kind of looked at by the FDA, and I think it's in the process of maybe being approved. But the bottom line is you can imagine that an insulin shot for a week, you may have greater risk for hypoglycemia than one that only lasts for 24 hours and then dissipates. So there may be some advantages in certain populations to only have to give an injection once a week and then they're covered. But on the other hand, the risks need to be carefully weighed against the benefits.