The physiology of incretin hormones and the basis for DPP-4 inhibitors.
With the rising prevalence of diabetes, new therapies that provide glucose control are needed. Although many medications are available, tight glucose control is still a challenge. In this article, the physiology of glucose homeostasis is explored with respect to type 2 diabetes. The incretin effect is explained in detail, and the incretin hormones, glucose-dependent insulinotrophic polypeptide and glucagon-like peptide 1, are investigated as well as their contribution to type 2 diabetes therapy. Studies involving dipeptidyl-peptidase 4 (DPP-4) inhibitors are summarized as to their effects on glucose homeostasis. Specifically, vildagliptin (Galvus; Novartis International AG, Basel, Switzerland) and sitagliptin (Januvia; Merck & Co, Inc, Whitehouse Station, NJ) are described. The use and efficacy of the currently available incretin mimetic, exenatide (Byetta; Amylin Pharmaceuticals, Inc and Eli Lilly and Company, San Diego, Calif, and Indianapolis, Ind), are briefly discussed. Throughout this article, the rationale for the use of DPP-4 inhibitors is presented.
McKennon
Skye Aiko
SA
The College of Pharmacy, Washington State University, Pullman
Campbell
R Keith
RK
The College of Pharmacy, Washington State University, Pullman
D000243:Adenosine Deaminase / Q000502:physiology*; D058892:Adenosine Deaminase Inhibitors; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D018819:Dipeptidyl Peptidase 4 / Q000502:physiology*; D054873:Dipeptidyl-Peptidase IV Inhibitors; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004763:Glucagon-Like Peptides / Q000037:antagonists & inhibitors / Q000502:physiology; D005947:Glucose / Q000378:metabolism; D006023:Glycoproteins / Q000037:antagonists & inhibitors / Q000502:physiology*; D006728:Hormones / Q000502:physiology; D006801:Humans
D058892:Adenosine Deaminase Inhibitors; D054873:Dipeptidyl-Peptidase IV Inhibitors; D004791:Enzyme Inhibitors; D006023:Glycoproteins; D006728:Hormones; D004763:Glucagon-Like Peptides; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4; D000243:Adenosine Deaminase; D005947:Glucose