Glucagon-like peptide 1 based therapy for type 2 diabetes.
BACKGROUND
Incidence of type 2 diabetes mellitus (T2DM) has increased in young people in recent years and new therapies are required for its effective treatment. Glucagon-like peptide 1 (GLP-1) is a potent blood glucose-lowering hormone produced in the L cells of the intestine. It may be potentially effective in the treatment of hyperglycemia in patients with T2DM.


METHODS
PubMed database were searched with the terms "GLP-1", "incretins" and "diabetes".


RESULTS
GLP-1 is a product of the glucagon gene, and its secretion is controlled by both neural and endocrine signals. GLP-1 lowers plasma glucose by stimulating insulin and suppressing secretion of glucagons, thus inhibiting gastric emptying and reducing appetite. GLP-1 exerts these actions by the engagement of structurally distinct G-protein-coupled receptors (GPCRs). In patients with T2DM, GLP-1 increases insulin secretion and normalizes both fasting and postprandial blood glucose when given as a continuous intravenous infusion. However, the native hormone is unsuitable as a drug because it is broken down rapidly by dipeptidyl peptidase IV (DPP-4) and cleared by the kidneys. Fortunately, many GLP-1 agonists or analogues and DPP-4 inhibitors have been found or developed, such as exendin-4, exenatide, liraglutide, CJC1131, vidaliptin and P32/98. Clinical trials have shown their therapeutic functions in T2DM with little adverse reaction.


CONCLUSIONS
A GLP-1 based therapy will be safe and effective for the treatment of T2DM.
Yu
Bao-Sheng
BS
Department of Pediatric Endocrinology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China. drbsyu@yahoo.com.cn
Wang
An-Ru
AR
D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000628:therapy*; D015316:Genetic Therapy; D052216:Glucagon-Like Peptide 1 / Q000819:agonists / Q000031:analogs & derivatives / Q000627:therapeutic use*; D000067757:Glucagon-Like Peptide-1 Receptor; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D054795:Incretins / Q000031:analogs & derivatives / Q000502:physiology / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D018027:Receptors, Glucagon / Q000819:agonists
D001786:Blood Glucose; C000593833:GLP1R protein, human; D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D018027:Receptors, Glucagon; D052216:Glucagon-Like Peptide 1