The therapeutic potential of a venomous lizard: the use of glucagon-like peptide-1 analogues in the critically ill.
Glucagon-like peptide-1 (GLP-1), a principal mediator of the postprandial insulinotropic response in health, has a half-life of minutes. The saliva of the Gila monster contains exendin-4, a structural analogue of human GLP-1, but with a much longer half-life. A synthetic preparation of exendin-4, exenatide, is suitable for human use and effectively lowers glucose in ambulant type 2 diabetic patients. When compared with insulin, exenatide therapy is associated with a reduction in hypoglycaemic episodes and postprandial glycaemic excursions in this group. Accordingly, GLP-1 analogues are appealing therapies for hyperglycaemia in the critically ill patient and warrant further study.
Deane
Adam M
AM
Discipline of Acute Care Medicine, University of Adelaide, North Terrace, Adelaide, South Australia, Australia. adam.deane@adelaide.edu.au
Chapman
Marianne J
MJ
Horowitz
Michael
M
D000818:Animals; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives* / Q000302:isolation & purification / Q000627:therapeutic use*; D006801:Humans; D008116:Lizards; D030162:Reptilian Proteins / Q000302:isolation & purification / Q000627:therapeutic use*; D014688:Venoms / Q000302:isolation & purification / Q000627:therapeutic use*
D030162:Reptilian Proteins; D014688:Venoms; D052216:Glucagon-Like Peptide 1