The incretin system and cardiometabolic disease.
Rates of type 2 diabetes, obesity and their associated detrimental cardiovascular effects are rapidly increasing. Despite the availability of several treatment options for type 2 diabetes and the use of intensive regimens combining several antidiabetic drugs, less than one-half of all patients reach a target glycosylated hemoglobin level of less than 7%. Disease progression due to ongoing deterioration of pancreatic islet cell health and beta-cell function is likely responsible. Therefore, there is a need to identify new pharmacological compounds that may not only treat hyperglycemia, but may also correct impaired glucose homeostasis and preserve endogenous beta-cell function. Identification and characterization of the incretin system and its effect on glucose homeostasis have resulted in the development of new antidiabetic agents that target these concerns. The current review examines the incretin effect and the pharmacological agents that have been developed based on the understanding of this physiological system. The influence of incretins on the cardiovascular system beyond the proatherogenic effect of type 2 diabetes will also be discussed.
Division of General Internal Medicine, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada.
Paul E
PE
Szmitko
Lawrence A
LA
Leiter
Subodh
S
Verma
D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D006801:Humans; D054795:Incretins / Q000502:physiology*; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*
D015415:Biomarkers; D001786:Blood Glucose; D054795:Incretins