Dipeptidyl peptidase-4 inhibitor

And again, it's a really similar number to Virta's one year results where they had 93% of insulin doses being ceased or decreased.

And as you'll see, the medications that were continued the most or even added were the GLP-1 agonist, DDP-4, and metformin.

And in many cases, these patients will have been de-escalated from the higher-risk medications.

So to explain this further, at Diversa, our docs would say that supporting someone with diabetes is not just about treating the main symptom of diabetes, which is the high blood glucose, but about not worsening the disease, which is that underlying insulin resistance.

One thing, like I said, the God-made GLP-1, the ones that our intestines produce, they have a half-life of just a couple minutes.

So your body's constantly producing them after a meal until the glucose load is gone and then the DPP-4 will bring it back down.

Now take this couple minutes and compare that to man-made GLP-1s that have a half-life of seven days.

So now instead of just slowing the gastric empty and so your glucose slowly comes out of the stomach and slowly gets in your blood, this actually paralyzes your stomach.

So if you can find somebody who does microdosing, then that would be a lot better.

You definitely don't want to be using all this man-made, these GLP-1s because there are so many adverse effects and things that you will not want to have happen to you.

Now, the other reason I brought up, I remember I brought up the DPP-4, that's the other hormone.

So once your body starts creating all this GLP-1 after a meal to try to keep your glucose levels down, after it does that and the food's out of your stomach and out of your intestines, it's all been broken down in glucose and put in your blood, the DPP-4 will now bring your insulin levels back down.

So half of it is gone in the time it takes to boil a kettle.

There's an enzyme called DPP-4 sitting in your blood vessel walls that chops it up almost immediately and your kidneys clear out the rest.

And I wanna be really clear here, that is not a design flaw.

To be honest, like, I don't know, I don't think many things in the human body are any types of design flaws, right? So that is the design.

and review level support for whey, casein, fish, and soy.

This is all gonna be in my recipe book.

There's a separate line of research on food-derived peptides that inhibit DPP-4, which is the enzyme that destroys your GLP-1 in a couple of minutes.

Milk and fish peptides both show this in laboratory studies.

But because of this risk, it is recommended that in- individuals that are at high risk or family history, especially family history of multiple endocrine neoplasia syndrome type 2 are avoid GLP-1 medication.

However, you can be rest assured and tell your patient, "Hey, listen, we've actually never shown this in patients." In fact, when we did the current largest study we've ever done, which was 100,000 GLP-1 users and two point five million DDP-4 users, followed them for a difference of three years.

It was an observational study in the Journal of Thyroid.

They were looking at rates of thyroid cancer among the GLP-1 and the DDP-4 users.

The difference was No difference.

There was no increased risk of thyroid cancer or i-i-- There just wasn't an increased risk of thyroid cancer with the GLP-1.

That is, that is possible.

That is possible.

Now, one of the things about this study was that they needed a comparative group.

And in this situation, they chose individuals who were treated with DPP-4 inhibitors, which are drugs that are used to treat diabetes.

So just one caveat here, we know now that the GLP-1s are used to treat a lot of conditions, obesity, obesity, they're used to treat cardiac disease, they're used in some types of renal disease.

So there's a broader usage.

So these two groups, one of them, the DPP-4, only included individuals with diabetes, whereas the group with the GLP-1s had a mixture of people with diabetes, people with just obesity or other medical concerns.

They propensity score matched them for the type of cancer.

And then they looked at which individuals progressed to developing metastatic disease.

They're probably not being treated with GLP-1s.