GLP-1: Uncovering the Body’s Metabolic Guardian

GLP-1 is like the body’s own “intelligent regulator.” It has the potential to become the nemesis of metabolic diseases.

It is linked to diabetes, obesity, heart disease, and other chronic diseases that many people have today. GLP-1 is a hormone that is produced in the intestines. It is becoming the focus of the medical community. When it was first discovered, GLP-1 only had one effect: lowering blood sugar. But since then, scientists have discovered that it has many other effects, such as helping people lose weight, protecting the heart, and preserving kidney function. These new findings have completely changed how metabolic diseases are treated. How does it work? It’s called a “smart regulator” for good reason. Let’s find out.

Ⅰ.The discovery of GLP-1: from intestinal signaling to medical revolution

In 1983, scientists first found GLP-1 in intestinal L cells. At first, they thought it only had a supporting role in the digestive system by stimulating insulin secretion to help digest sugar in food. But as scientists kept studying it, they found that this 30-amino-acid hormone is actually a “master key” that controls the whole body’s metabolism.

Ⅱ. Four core functions of GLP-1

1. Blood Sugar “Precision Regulator”: It reduces high blood sugar without harming normal values.The most amazing ability of GLP-1 is its “intelligent glucose lowering” mechanism:

• Glucose-dependent insulin secretion: when blood glucose rises (e.g. after a meal), GLP-1 activates certain cells in the pancreas, causing the body to release a lot of insulin. When blood glucose is normal, this effect is automatically weaker, which can perfectly avoid the risk of low blood sugar (hypoglycemia) associated with traditional hypoglycemic drugs.

• Dual-pronged blood glucose control: It does this by stopping the release of glucagon (a hormone that increases blood sugar) by certain cells in the pancreas and by reducing the production of glucose (sugar) in the liver at the same time. This creates a closed loop that reduces glucose levels by “opening the source and slowing the flow.”

2. Weight “invisible housekeeper”: controlling appetite and metabolism.

• Central appetite suppression: GLP-1 can cross the blood-brain barrier and act directly on the satiety center of the hypothalamus, so that people can “eat less but not feel hungry.”

• It also controls how quickly food moves through your stomach, which makes you feel full for a longer time.

• Optimized Metabolism: It helps burn extra calories by changing white fat into brown fat, which generates heat.

3. Organ “Guardian Shield”: Whole Body Protection Beyond Metabolism

• The latest research reveals that GLP-1 receptors are found throughout the body, including the heart, brain, kidneys, liver, and other organs:

• Cardiovascular system: improve how energy is used by the heart, stop the formation of plaque in arteries, and large-scale clinical trials have confirmed that it can reduce the risk of heart attack and stroke by 14% to 26%.

• Nervous system: It can help protect the neurons in the hippocampus, which is important for memory. In animal studies, it has shown promise in treating Alzheimer’s disease and Parkinson’s disease.
• It can also protect the kidneys by reducing protein in the urine and slowing the progression of diabetic kidney disease.

4. It’s like a “regeneration engine” for the cells in the pancreas.

• Long-lasting high blood sugar levels can damage the cells in the pancreas that produce insulin (pancreatic β-cells). GLP-1 can help these cells grow.

• Activate the genes that promote cell growth, and encourage the creation of new cells.
• It also blocks signals that tell cells to die, which means existing β-cells live longer.
• It also improves insulin resistance and helps the body’s ability to regulate blood sugar.

Ⅲ. From natural hormone to “super drug”: the rise of GLP-1 agonists.

Natural GLP-1 is only active for 2 minutes before it is broken down by a special enzyme in the body. Scientists are working to overcome this limitation in two ways:

1. They can modify the peptide chains artificially, for example, using liraglutide and simethicone. They can also prolong the duration of action through fatty acid chains, enabling weekly injections.
2. They can also stop the enzyme that breaks down GLP-1, which is called DPP-4. Some drugs that do this are called DPP-4 inhibitors, like selegiline.

The clinical benefits are significant:

For example, glycated hemoglobin (HbA1c) decreased by an average of 1.0% to 1.8% in patients with type 2 diabetes.
They can also cause weight loss of up to 5% to 15% of body weight (for example, the STEP clinical trial of simethicone).
The US FDA has approved its use for the priority treatment of diabetes combined with cardiovascular disease.

IV. Future outlook: paradigm shift from treatment to prevention

Right now, there is a lot of research being done on GLP-1 in a bunch of different areas.

Non-alcoholic fatty liver disease: reducing inflammation by blocking the production of fat in the liver.
Polycystic ovary syndrome: regulating sex hormone levels and restoring ovulation function.
Neurodegenerative diseases: Clinical trials for Alzheimer’s disease are now in phase III.
There has been a breakthrough in oral preparation: the launch of simethicone tablets has made the “injection to medicine” a reality.