Oh, hey, it's still your broken pancreas, and unfortunately I'm still not

alleyward. But I am Mike Natter, happy to introduce round two of Diapetology. This

again was filmed back in 2019, so things have changed a little bit. Here we are

answering and talking about some questions from the Patreon page for

allergies, and I did want to update a couple of quick things. We didn't talk at

all in this episode about GLP1 receptor agonist. These are things like

ozempic and wagovii and manjara, and they've made a big splash right now,

especially now, in the diabetes world and the weight loss world, and I have to

say I am using a lot of them with my patients. I am seeing a lot of benefit

from them, but like every medication, there's indications, and there's always

side effects and adverse events. So how do these things work? Well GLP1

stands for glucagon-like peptide 1. Manjara is actually 2 and 1. It's GLP1 and

GIP gastric inhibitory peptide, and our bodies make these what are known as

incretins naturally from our small intestine. Once released into the blood

stream, they talk to the pancreas, they talk to the liver, they talk to the

receptors, and they make the body more prime to make insulin and be more

receptive to that insulin. But they also talk to the part of the brain called

hypothalamus, and it tells the hypothalamus, hey, satiety center get turned on.

You are now full, so mentally you feel full, and it talks to our gastric

tract, and the tract is making these kind of parasitaltic movements. It moves

at a certain rate, it slows that rate down. So it's slowing that rate down.

We're physically full, we're mentally full, we eat less. One other thing I

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