Diabetes Breakthroughs: Januvia and Janumet

I do not recommend this, but let’s just suppose that for breakfast you had a waffle drenched in maple syrup, a large glass of orange juice, and coffee with two teaspoons of sugar. What happens next? Your breakfast is full of carbohydrates. The waffle contains complex carbohydrates (starches) from the flour, and the orange juice, syrup, and sugared coffee contain simple carbohydrates (sugars). The sugar in orange juice and syrup is mostly fructose, and that in your coffee is sucrose. In the intestines, the starches are slowly broken down into the sugar glucose; the sucrose is split into equal amounts of glucose and fructose. The fructose can be converted to glucose in the liver. The sugars from the orange juice, syrup, and coffee enter the blood quickly; those from the starches in the waffle enter more slowly. However, they all act to increase blood glucose levels. A basic principle of human physiology is summed up in one word—homeostasis, which simply means that when the normal metabolic status of the human body is changed in some way, the body responds by restoring normality. When something changes, the body fights back to eliminate or minimize the change. This is what happens when blood glucose is elevated in response to a meal. Here is how. The pancreas is a medium-size organ in the abdomen that secretes enzymes into the gut to aid in digestion, and endocrine hormones into the bloodstream to control some aspects of metabolism. The pancreas responds to sugar entering the bloodstream by secreting the peptide hormone insulin into the circulation. Insulin is made in specialized cells of the pancreas known as the beta cells of the islets of Langerhans. Insulin has a critical role in the regulation of blood glucose levels. Acting through its receptor, insulin causes glucose in the blood to be taken up by muscle and fat cells, reducing the blood glucose level.