[Kim Jaeho's Life Story]<249>The Pros and Cons of Oral Hypoglycemic Agents

When people develop an illness and take medication, they naturally expect the medicine to cure their disease, but it is rare for the medicine to completely heal the condition as hoped. Most medications tend to alleviate symptoms to some extent rather than curing the disease itself, and blood sugar-lowering drugs and blood pressure-lowering drugs are among such medications.

Many people around us take blood sugar-lowering drugs for type 2 diabetes, but since these drugs do not cure diabetes and only temporarily lower blood sugar levels, it is important to remember how they affect our bodies.

The cells in our body primarily obtain the energy they need for activity from glucose in the blood sugar. Because we are constantly active, including during rest and sleep, blood sugar is needed throughout the 24 hours, although there are hourly fluctuations.

To meet this demand for blood sugar, it is necessary to supply an appropriate amount. If blood sugar is not supplied as needed, cells cannot produce the energy required and cannot survive, let alone function. Conversely, if blood sugar is supplied excessively beyond demand, cells including blood vessels and nerves get damaged, and we cannot live healthily. However, the supply of blood sugar varies greatly by time. After a meal, when food is digested and glucose is absorbed all at once, blood sugar supply surges sharply and then ceases completely once digestion is finished.

Therefore, it is necessary to adjust blood sugar supply according to demand. Fortunately, our bodies have a perfect automatic blood sugar regulation system that can solve this imbalance without any problem, allowing us to live healthily.

When blood sugar rises excessively due to digestion, the pancreas secretes the hormone insulin. As insulin travels through the blood vessels, it stimulates receptors on cells, causing cells to absorb blood sugar for energy production. At the same time, it stimulates liver cells to convert glucose in the blood sugar into glycogen, which is stored in the liver and muscles, thereby lowering blood sugar to an appropriate level.

When digestion ends and blood sugar is no longer supplied, the pancreas secretes the hormone glucagon, which breaks down glycogen stored in the liver and muscles into glucose, raising blood sugar to an appropriate level. Because this system functions normally, blood sugar is maintained at a proper level, enabling us to live healthy lives.

Diabetes is a disease related to problems with the insulin hormone, which plays a crucial role in blood sugar regulation, and it has two forms. Type 1 diabetes, also called juvenile diabetes, occurs when insulin is not properly produced, causing excessively high blood sugar. Type 2 diabetes occurs when insulin is produced normally, but the receptors on cells do not respond properly to insulin, accounting for about 90% of cases.

The cause of type 2 diabetes is insulin resistance, where cell receptors do not respond well to insulin. Insulin resistance is caused by poor lifestyle habits, including lack of exercise and unhealthy eating habits. Insulin resistance can be improved relatively easily by changing these poor lifestyle habits, but many people prefer to rely on oral blood sugar-lowering drugs rather than normalizing the malfunctioning automatic blood sugar regulation system by changing their lifestyle.

There are various types of blood sugar-lowering drugs that reduce elevated blood sugar caused by type 2 diabetes, each with different side effects. The first type acts on the pancreatic beta cells that produce insulin, promoting insulin secretion. These include sulfonylureas, meglitinides, and DPP-4 inhibitors, which carry a serious risk of hypoglycemia.

The second type does not affect insulin secretion but enhances insulin action. These include biguanides, which act on peripheral tissues, and thiazolidinediones, which reduce insulin resistance in muscles and liver and suppress glucose production in the liver. Biguanides often cause gastrointestinal side effects such as nausea and diarrhea, while thiazolidinediones have side effects including weight gain, heart enlargement, and decreased bone density.

The third type inhibits glucose absorption or reabsorption. Alpha-glucosidase inhibitors delay absorption by inhibiting digestive enzymes that break down disaccharides, oligosaccharides, and polysaccharides into glucose in the small intestine. SGLT2 inhibitors block glucose reabsorption in the kidneys, causing glucose to be excreted in the urine.

As seen above, oral blood sugar-lowering drugs temporarily lower blood sugar but do not normalize the malfunctioning automatic blood sugar regulation system to cure diabetes. Instead, they maintain the malfunctioning state while modifying or distorting some functions, leading to various side effects and a high likelihood of complications such as diabetic retinopathy or diabetic neuropathy over time.

People with diabetes, who have persistently high blood sugar levels above the appropriate range, may feel tempted to rely on blood sugar-lowering drugs that temporarily reduce blood sugar. However, even if these drugs are used temporarily, it is crucial to normalize the automatic blood sugar regulation function through a Newstart lifestyle (see Life Story Part 6) that creates the best environment for the top expert inside your body to work well, thereby curing diabetes.

The first of the eight Newstart items, Life Diet, involves eating a variety of plant-based foods including fruits, vegetables, and grains in their whole form without favoring specific foods. Along with this, it is important to reduce intake of sugar?which causes many problems when consumed excessively?as well as processed or refined bad carbohydrates, saturated fats, trans fats, salt, and alcohol.

Additionally, practicing the remaining Newstart items?exercise, water, sunlight, temperance, air, rest, trust, and love?is also important.