Thanks, you flatter me. I don’t understand GLP-1 analogs very well, but they are used by Dr. Nally for patients who are not getting their blood sugar under control with keto. I should probably talk about these as a class of drugs called incretin mimetics. They are injectable drugs.
The drug I heard Dr. Nally discuss on the Keto Talk podcast was Symlin, which is a synthetic version of the hormone amylin, or an amylin analog. I think (but can’t say 100%) that it is different from the other incretin mimetcs in that it provides a substitute for amylin instead of stimulating your body’s production of amylin. Amylin is the hormone that tells glucagon to stop telling the liver to make more glucose. It seems that if amylin is low, then the liver over-produces glucose, which would explain high blood glucose readings in the absence of a high carb diet. (@VLC.MD found some info about scary potential side-effects of Symlin, FYI.)
Victoza is a true GLP-1 mimetic, and I heard Nally mention that one in passing on a “Doc Talk” video. He thinks it is fantastic, but didn’t get into it more than that. GLP-1 mimetics work to lower blood glucose by increasing the body’s secretion of insulin (I am not a fan of that part), slowing gastric emptying and making you feel full, and decreasing glucagon. Dr. Richard Bernstein uses these products to assist with weight loss because of the improved satiety (he goes into these in detail in his book Dr. Bernstein’s Diabetes Solution Ch. 13 “How to Curb Carbohydrate Craving.”)
I need to research more on the risk of the dangers of taking Symlin. To me it sounds like just what I need, or at least I won’t know unless I try it. (There is no way to test for amylin levels apparently. So if it’s low, I would know if it improves with Symlin.) It is very tempting, because it seems like nothing else works and there is no good explanation for how high my blood glucose goes on keto than if my liver is over-producing glucose – there is nothing to tell the glucagon to shut up.
However, maybe this will get better with more fasting. There has been some improvement, though without extended fasting the sugars seem to just climb right up. I have yet to try consistently doing a 42-hour schedule. I should probably give that a shot before going to pharmaceuticals (I have given them enough money over the years).
Then there is that pesky question of dairy. I keep reading “some people react badly to dairy” in terms of blood glucose. I want to research that further.
By the way, I am going to start a blog because I need somewhere to keep track of all these things I am exploring. It is hard - you read about something in a forum or hear it on a podcast and it sounds like something worth checking out, but life gets busy and it slips away…
Anyway that is my attempt to summarize about incretin mimetics including GLP-1 and amylin analogs.