Chapter 23 Type 2 Diabetes
Type 2 diabetes is a chronic systemic disease caused by metabolic disorders of the body.
Before talking about type 2 diabetes, we have to explain the concept of diabetes.
When I was in kindergarten, the senior class teacher taught me that it does not mean that the stuff produced by the disease is sweet, it means diabetes.
Diabetes refers to a systemic metabolic disease in which blood sugar concentration is too high. Simply put, it is hyperglycemia.
There are two types of diabetes, type 1 diabetes and type 2 diabetes.
The reason why patients with type 1 diabetes suffer is very simple, that is, the body lacks or is unable to secrete insulin due to various reasons.
Insulin is a key hormone that regulates blood sugar levels. The principle of lowering blood sugar is not to melt and decompose glucose in the blood, but to send commands to cells to eat glucose.
People with type 1 diabetes lack insulin in their bodies, so their cells are disobedient and unwilling to remove glucose from the blood.
Excess glucose exists in the blood, naturally forming hyperglycemia.
But type 2 diabetes is different. Type 2 diabetes is related to multiple causes of damage to pancreatic islet cells, insulin deficiency, and insulin resistance.
However, research shows that the main cause of type 2 diabetes is insulin resistance!
90% of patients with type 2 diabetes are accompanied by insulin resistance.
The so-called insulin resistance means that the cells of the patient's body are no longer sensitive to insulin.
Simply put, insulin gives instructions to cells to eat glucose in the blood.
But the cells disobeyed.
Hey, just go ahead and call for insulin. If you tell me to eat, I will eat it. My cells don’t want to lose face!
I won’t eat today. I’ll see what you can do to me!
Then, the cells rebelled.
At this time, insulin has no choice but to watch the blood sugar in the blood increase.
As a result, type 2 diabetes occurred.
Compared with chronic myelogenous leukemia, type 2 diabetes is not a terminal disease.
But in the absence of other drugs, the treatment of type 2 diabetes is definitely not cheap.
As far as Lu Liang knows, there is currently only one drug on the market that can be used to treat type 2 diabetes—liraglutide.
Liraglutide, a human glucagon-like peptide-1 analog.
It promotes insulin secretion, inhibits glucagon secretion in a glucose concentration-dependent manner, and exerts a hypoglycemic effect by improving insulin resistance, delaying gastric emptying and suppressing central appetite, thereby achieving the purpose of treating type 2 diabetes.
However, Lu Liang did not care about the molecular mechanism of liraglutide.
There is only one thing he cares about, and that is the price of liraglutide.
Currently on the market, liraglutide is priced at 1,000 yuan/tube!
The dosage of 1 vial of liraglutide is 3ml!
This means that the average price of 1ml of medicine is more than 300 yuan.
What kind of concept is this? One gram of gold only costs more than 300!
The price of liraglutide is already equivalent to gold.
The most important thing is that there are many patients with type 2 diabetes around the world. Just relying on this drug, Nordisk and the company that produces liraglutide can make a lot of money every year.
If I can analyze a new drug from liraglutide, the source points I can obtain will definitely far exceed those brought by Bai Shuke.
Thinking of this, Lu Liang began to feel a little unbearable.
However, no matter how anxious you are, things have to be done step by step.
Because, before analyzing the medicine, Lu Liang had one more thing to do.
That is to first understand the pathology and mechanism of type 2 diabetes.
Lu Liang didn't know much about type 2 diabetes, and he couldn't develop a treatment drug for type 2 diabetes without knowing anything about it.
At that time, everyone will realize that there is something wrong with him.
Therefore, you still need to have basic common sense.
Lu Liang put the computer down on the library table. After opening the pubmed database, Lu Liang entered the two keywords insulin resistance and type 2 diabetes in the search bar.
Soon, a large body of literature appeared on the screen about insulin resistance and type 2 diabetes.
Lu Liang briefly screened and found the research findings of the past ten years, then copied the doi one by one and downloaded it on scihub.
It has to be said that if there were no free literature download websites, Lu Liang would be too poor to look down on literature. After all, the price of literature on the official website is basically more than ten dollars per article.
At this price, Lu Liang would not be willing to part with it no matter how rich he was.
With a crisp ding-dong sound, the document in PDF format has been downloaded. Lu Liang directly threw the entire document into the translation software and started machine translation.
The results of the computer translation came out quickly, and Lu Liang began to read the documents carefully.
In many type 2 diabetes research literature, insulin resistance is identified as the main factor inducing type 2 diabetes.
Therefore, insulin resistance has become a critical point that cannot be avoided.
Following this line of thought, Lu Liang began to read relevant literature on insulin resistance.
Insulin resistance means that when the amount of insulin secreted is at normal levels, the physiological effects of stimulating target cells and utilizing glucose are significantly weakened. Fatty insulin resistance is one of the manifestations of lipid metabolism disorders.
Inflammation, obesity and other factors are important factors in inducing insulin resistance, especially obesity.
Obesity is mainly characterized by reduced sugar uptake by adipocytes and increased fat catabolism, leading to an increase in free fatty acids in the blood and ectopic fat deposition.
Lu Liang frowned and began to think. He flipped through the document in front of him. This was a study on lipid metabolism, and the content involved insulin resistance.
Lipid metabolism is indeed closely related to insulin resistance in a sense.
But this was not the document Lu Liang was looking for.
After closing this document, Lu Liang reopened another document.
Intestinal microbiota has a significant improvement effect on the body's insulin resistance.
We just got rid of the relationship with lipid metabolism, why are we still involved with the intestinal microflora?
Lu Liang was confused for a moment.
He found that intestinal microorganisms seem to have become a hot topic in the academic field. No matter what they are, they are more or less related to intestinal microorganisms.
There are even studies on gut microbes improving Parkinson's disease.
This thing is like a panacea and can be used anywhere.
Lu Liang continued to dig deep into the literature for the research he wanted, and soon he found what he wanted.
Before explaining insulin resistance, we have to mention a signaling pathway, which is the insulin signaling pathway.
The signaling pathway consists of the insulin receptor substrate 1/phosphatidylinositol 3-kinase/protein kinase B pathway (IRS-1/PI3K/AKT), which plays a crucial role in the transmission of insulin signals.
Lu Liang continued to search the literature along the insulin signaling pathway.
Ser307 phosphorylation of IRS-1 is an important marker of insulin resistance in the body
As he dug deeper layer by layer, Lu Liang was now completely immersed in learning.
This kind of continuous digging and learning along the existing ideas gives Lu Liang a kind of joy of peeling off cocoons.
It was as if the truth was close at hand.
Just like that, time passed quickly, and by the time Lu Liang raised his head from the computer screen again, it was already dark.