Sympathetic effects and mediation: Sympathetic nerves inhibit insulin and stimulate glucagon secretion. Their activation may help mediate stress-induced changes in islet hormone secretion including the glucagon counterregulatory response to hypoglycemia.These effects may be mediated by the combination of the classical neurotransmitter noradrenaline and the sympathetic neuropeptides (galanin and NPY). All three neurotransmitters can inhibit insulin and stimulate glucagon secretion, thus mimicking the effects of sympathetic activation on islet hormone secretion. In addition, galanin and NPY meet several other of the criteria needed to be classified as a physiologic neurotransmitter.

Combination therapy resulting in superior glycemic control, weight loss versus either agent alone

Ertugliflozin provides clinically significant reductions in blood glucose levels.

A single, once-daily injection to lower both fasting and postprandial blood glucose

Are clinicians intensifying treatment before it is too late?

Initiation of glucagon like peptide-1 agonists may increase risk of gallbladder or bile duct disease and cholecystectomy; no increased risk associated with DPP-4 inhibitor therapy.

In part 2 of this exclusive interview from AACE 2016, Dr. Garvey discusses the available tools -- medication, surgery, lifestyle interventions - to combat obesity, and which strategies are most effective.

In part 1 of this exclusive interview from AACE 2016, Dr. Timothy Garvey discusses the new comprehensive clinical practice guidelines for patients with obesity.

Please select the drug class that best fits the description. This shorter-acting insulin secretagogue may be associated with less hypoglycemia than the other secretagogues. 1. Biguanides 2. Sulfonylureas 3. Meglitinides 4. Thiazolidinediones Did you get it right? Follow the link to check your answer.

Should we be more aggressive for people with prediabetes and use more of the drugs we have available, rather than waiting until they progress to diabetes? Follow the link to share your opinion!