From insulin to tesiparatide: the evolution of diabetes drugs and new treatment options
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Diabetes is one of the most common chronic metabolic diseases worldwide, affecting the health of hundreds of millions of people. From the discovery of insulin in 1921 to the groundbreaking advancements of GLP-1 receptor agonists (such as tesipatide), diabetes treatments have undergone a dramatic transformation. Today we'll take you through a century of evolution in diabetes medications , highlighting how next-generation GLP-1 receptor agonists, such as tesipatide, are changing the landscape of diabetes treatment. If you or your family are looking for safer, more effective diabetes management options, this article will provide you with key information.
I. Milestones in Diabetes Treatment: From Insulin to Modern Targeted Therapies
1. The discovery of insulin (1921): The first revolution in the treatment of diabetes.
Before the discovery of insulin, type 1 diabetes (T1DM) was almost a death sentence, with patients only able to prolong their lives briefly through extremely low-calorie diets. In 1921, Canadian scientists Frederick Banting and Charles Best successfully extracted insulin from the pancreas of animals and used it for the first time to treat diabetic children. This discovery completely changed the fate of patients with type 1 diabetes, making insulin the cornerstone of diabetes treatment.
Limitations of insulin:
● Requires injection, resulting in low patient compliance.
● Higher risk of hypoglycemia
● For patients with type 2 diabetes (T2DM), long-term use may lead to weight gain.
2. The Era of Oral Hypoglycemic Drugs (1950s-1990s): The Rise of Drugs such as Metformin and Sulfonylureas
With the surge in the incidence of type 2 diabetes, scientists have begun developing oral hypoglycemic drugs to reduce insulin dependence.
● Sulfonylureas (1950s) : They lower blood sugar by stimulating the pancreas to secrete insulin, but they have a higher risk of hypoglycemia.
● Metformin (discovered in 1957 and widely used since 1995) : Reduces hepatic glucose output and improves insulin sensitivity; it remains a first-line drug for type 2 diabetes.
● Thiazolidinediones (TZDs, 1990s) : Improve insulin resistance, but may increase the risk of heart failure.
3. Breakthroughs in the 21st Century: GLP-1 Receptor Agonists and SGLT-2 Inhibitors
In the 21st century, diabetes treatment no longer focuses solely on blood sugar control, but also takes into account cardiovascular protection, weight management, and kidney benefits .
● GLP-1 receptor agonists (launched in 2005) : Lower blood sugar by enhancing insulin secretion, inhibiting glucagon, and delaying gastric emptying, while also helping with weight loss.
● SGLT-2 inhibitors (launched in 2013) : Lower blood sugar by excreting sugar in urine and have cardioprotective and renal protective effects.
II. GLP-1 receptor agonists: A new hope for diabetes treatment
1. What is GLP-1?
GLP-1 (glucagon-like peptide-1) is an intestinal hormone secreted by L cells in the intestine after eating, and its functions include:
✅ Promotes insulin secretion (for blood sugar-dependent conditions, with a low risk of hypoglycemia)
✅Inhibits glucagon secretion (reduces hepatic glucose output)
✅Slows down gastric emptying (increases satiety and helps with weight loss)
✅Protects beta cell function (delays the progression of diabetes)
2. Evolution of GLP-1 receptor agonists
|
drug |
Launch date |
Features |
|
Exenatide (Byetta) |
2005 |
Short-acting, requires twice-daily injections. |
|
Liraglutide (Victoza) |
2010 |
Once-daily injection provides clear cardiovascular benefits. |
|
Smegglutinin (Ozempic/Wegovy) |
2017 |
One injection per week for powerful blood sugar reduction and weight loss. |
|
Tirzepatide |
2022 |
GLP-1 + GIP dual receptor agonists offer stronger blood sugar lowering and weight loss effects. |
3. Tirzepatide: A new generation of "dual-target" hypoglycemic drugs
Tsipatide (trade name Mounjaro ) is the first GLP-1/GIP dual receptor agonist . It was approved by the FDA in 2022 for the treatment of type 2 diabetes and has shown remarkable effects in the weight loss indication (clinical trials showed an average weight loss of 15%-22%).
The three major advantages of tesipatide:
1. More effective blood glucose control : In the SURPASS clinical trial, tesipatide showed better blood glucose lowering effect than smegglutide and insulin.
2. Significant weight loss effect : Many patients lose 10%-20% of their weight after using it, which is even better than GLP-1 drugs alone.
3. Potential cardiovascular and metabolic benefits : Studies show that it may reduce the risk of heart disease and stroke.
III. How to choose the most suitable diabetes medication
Diabetes treatment needs to be individualized , and the following should be considered when choosing medication:
✔ Blood glucose control target (HbA1c level)
✔ Weight management needs (whether weight loss is required)
✔ Cardiovascular and kidney risks (whether there is heart failure or chronic kidney disease)
✔ Convenience of medication (oral or injectable, daily or weekly)
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⚠️ Friendly reminder: This article is for reference only. Please consult your doctor for specific medication advice.