Incretin based therapies for type 2 diabetes mellitus.
The incretin effect denominates the phenomenon that oral glucose elicits a higher insulin response than intravenous glucose. Glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide are the principal hormones responsible for incretin effect. In patients with type 2 diabetes the incretin effect of these hormones is impaired. Therapeutic approaches for enhancing the incretin action include degradation resistant GLP-1 receptor agonists (incretin mimetics) and inhibitors of dipeptidyl peptidase-IV (DLP-IV) activity (incretin enhancers- gliptins). These groups of medications have similar efficacy with regards to glycaemic improvement (reduction of HbA1c between 0.5 to 1.1%) and have side-effects like nausea. The incretin mimetics are injectable agents and are more likely to reduce weight or be weight neutral when compared to the oral gliptins. Long-term studies are essential to determine the real potential and role of these newer agents in the management of type 2 diabetes.
Department of Medicine and Endocrinology, The Ayr Hospital, Ayr, Scotland, United Kingdom.
Sujov
S
Ghosh
Andrew
A
Collier
Tarik
T
Elhadd
Iqbal
I
Malik
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004152:Dipeptidyl-Peptidases and Tripeptidyl-Peptidases / Q000037:antagonists & inhibitors; D052216:Glucagon-Like Peptide 1 / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D054795:Incretins / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin
D054795:Incretins; D007328:Insulin; D052216:Glucagon-Like Peptide 1; D004152:Dipeptidyl-Peptidases and Tripeptidyl-Peptidases