Distinguishing among incretin-based therapies. Pathophysiology of type 2 diabetes mellitus: potential role of incretin-based therapies.
The multifactorial nature of the pathogenesis of T2DM provides an opportunity to combine treatments that act upon different mechanisms. In addition to improving insulin resistance and pancreatic β-cell dysfunction, the GLP-1 agonists and DPP-4 inhibitors improve the impaired incretin response, as well as increase insulin secretion and reduce glucagon secretion, both in a glucose-dependent manner. As a result of these multiple actions, the GLP-1 agonists and DPP-4 inhibitors lower both fasting and postprandial glucose levels. The effects of GLP-1 agonists tend to be greater, probably because they produce pharmacologic levels of GLP-1 compared to physiologic levels with the DPP-4 inhibitors. Another difference is that unlike the DPP-4 inhibitors, the GLP-1 agonists also slow gastric emptying and promote satiety.
Campbell
R Keith
RK
Department of Pharmacotherapy, Washington State University College of Pharmacy, Pullman, WA, USA.
Cobble
Michael E
ME
Reid
Timothy S
TS
Shomali
Mansur E
ME
D000218:Adamantane / Q000031:analogs & derivatives / Q000627:therapeutic use; D000368:Aged; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology*; D004151:Dipeptides / Q000627:therapeutic use; D000077270:Exenatide; D005260:Female; D005934:Glucagon / Q000378:metabolism / Q000627:therapeutic use; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D054795:Incretins / Q000627:therapeutic use*; D050417:Insulin-Secreting Cells / Q000502:physiology; D000069450:Liraglutide; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010455:Peptides / Q000627:therapeutic use; D011719:Pyrazines / Q000627:therapeutic use; D012720:Severity of Illness Index; D000068900:Sitagliptin Phosphate; D013997:Time Factors; D014230:Triazoles / Q000627:therapeutic use; D014688:Venoms / Q000627:therapeutic use
D001786:Blood Glucose; D004151:Dipeptides; D007004:Hypoglycemic Agents; D054795:Incretins; D010455:Peptides; D011719:Pyrazines; D014230:Triazoles; D014688:Venoms; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1; D005934:Glucagon; D008687:Metformin; C502994:saxagliptin; D000077270:Exenatide; D000218:Adamantane; D000068900:Sitagliptin Phosphate