The therapeutic role of incretin mimetics and DPP-4 inhibitors.
OBJECTIVE
Gastric inhibitory peptide (GIP) and glucagon-like peptide-1 (GLP-1) stimulate the secretion of insulin when blood glucose levels are elevated and inhibit the postprandial release of glucagon. An increased understanding of the role of these incretin hormones in insulin and blood glucose regulation has resulted in the development of new types of medications for managing diabetes. GLP-1 agonists and dipeptidyl peptidase-IV (DPP-4) inhibitors are 2 classes of medications that have been shown to offer benefits for patients with type 2 diabetes. To use and teach patients how to use these medications effectively, educators need to understand their mechanisms of action, indications and contraindications, side effects, and effectiveness. Expanding the number of options available has increased the complexity of providing care and education, but also offers new opportunities to help our patients achieve better outcomes.


CONCLUSIONS
This article provides an overview of the physiology of insulin regulation and the roles of GIP, GLP-1, and DPP-4; discusses how the action of incretin hormones is affected by diabetes; and describes the therapeutic agents in these classes and their potential use by people with diabetes.
Funnell
Martha M
MM
Michigan Diabetes Research and Training Center, Ann Arbor, Michigan 48109-0489, USA. mfunnell@umich.edu
D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D000077270:Exenatide; D005749:Gastric Inhibitory Polypeptide / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D054795:Incretins / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D010455:Peptides / Q000627:therapeutic use; D019518:Postprandial Period; D011480:Protease Inhibitors / Q000627:therapeutic use*; D011719:Pyrazines / Q000627:therapeutic use; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000627:therapeutic use; D014688:Venoms / Q000627:therapeutic use
D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D010455:Peptides; D011480:Protease Inhibitors; D011719:Pyrazines; D014230:Triazoles; D014688:Venoms; D005749:Gastric Inhibitory Polypeptide; D000077270:Exenatide; D000068900:Sitagliptin Phosphate