GUY’S GOTTA TALK ABOUT…DIABETES #7: HOW Exactly Do Metformin, Glipizide, Insulin, Ozempic, and Etc…Work Together?

For the first time since I started this column eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s called Type 1 diabetes. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome to join me! Today: What does Metformin do?

“…metformin reduces blood glucose through inhibition of complex IV activity which in turn leads to inhibition of glycerol phosphate dehydrogenase activity and reductions in glycerol conversion to glucose”.

OK – I need to translate this…honestly, even for me (BS – Biology, MS – Counseling), it seems a bit language heavy!

Metformin – I take four Tylenol-shaped tablets a day. To be honest, it has NEVER brought my blood sugars down to what they are “supposed to be”. They range from the highest overnight fasting I’ve ever had of 205; to the lowest overnight fasting I’ve ever had of 143. The literature indicates that I should be 130 or less. So, is the Metformin doing what it’s supposed to? I don’t know – I’ll be talking with the doctor in April.

“inhibition of complex IV” – This complex is involved with taking energy that’s stored in cells in a sort of “stable” package, and changing it into an active package that the cell can use. The HECK?!?!?!? OK – I’ll break it down. According to Wikipedia: “The molecular mechanism of metformin is not completely understood.” Why does that make me nervous? In addition to a lot of other things, it works on “complex IV (or 4) –mediated inhibition of the GPD2 variant of mitochondrial glycerol-3-phosphate dehydrogenase (thereby reducing glycerol-derived hepatic gluconeogenesis)” SIMPLIFIED translation: it interferes with how the body makes sugar in the liver to dump into the blood. IOW, it slows down the release of glucose from the liver into the blood. Metformin decreases gluconeogenesis (glucose production) in the liver…The average patient with type 2 diabetes produces three times the normal rate of glucose! Metformin treatment reduces this by over one-third.”

Glipizide: “Glipizide sensitizes the beta cells of the pancreas’ insulin response”…

And that means, WHAT? OK, everyone reading this has a pancreas. It sits on top of the stomach and helps you digest food – and it makes insulin. Insulin allows your body to break down “real food” into its pieces, that is into GLUCOSE. “Glipizide makes the pancreas release more insulin to pick up the glucose and either use it or store it. than would be without glipizide ingestion. Glipizide acts by partially blocking potassium channels in the pancreas. The cell depolarizes, opens calcium channels, which encourages insulin release from beta cells (the cells that MAKE insulin in the pancreas.”

Insulin: If you’re a Type 2 diabetic, then by this point, you likely know what insulin is. If you’re new to this, insulin is a hormone (like testosterone, estrogen, adrenaline, melatonin…the list is very long…). If you missed the definition above: “Insulin allows your body to break down “real food” into its pieces, that is GLUCOSE”.

Ozempic®, etc: a HUGE group of drugs used to treat Type 2 diabetes, particularly those of us who are overweight (ie: FAT). Some of the brand names besides Ozempic®: Trulicity®, Farxiga®, Bydureon®, Victoza®, Adlyxin®, Jardiance®, and a host of others – all work in ways similar to Glipizide.

They all are designed to do the following: help the pancreas release insulin when blood sugar levels are high; help move sugar out of the blood and into other body tissues where it is used for energy; and slow the movement of food through the stomach in order to decrease appetite and promote weight loss. (See my post two weeks ago regarding the circus THAT has turned into!)

This gave me a better point of view to what’s happening in my own body as I continue to try and being my blood sugars under control. Hope it helped you, too.

Source: https://medicine.yale.edu/news-article/how-a-widely-used-diabetes-medication-actually-works/
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg