title: Incretin-based therapies for type 2 diabetes mellitus: effects on insulin resistance.
abstract: Insulin resistance has been associated with the development of type 2 diabetes, obesity, hypertension, dyslipidemia, atherosclerosis, and thus with increased cardiovascular morbidity and mortality. Insulin resistance precedes the onset of type 2 diabetes by many years. Targeting the pathophysiologic defects that characterize the onset of diabetes is more likely to achieve a durable glucose control and to delay disease progression. Incretins are gut-derived peptides that stimulate in a glucose-dependent mechanism insulin secretion and action. Glucose-like peptide 1 (GLP-1) analogues and dipeptidyl peptidase-4 (DPP-4) inhibitors both decrease fasting and postprandial glucose levels. In addition, GLP-1 analogues promote weight loss and exert a favorable effect on several cardiovascular risk factors. Data from human and experimental studies implicate that GLP-1 analogues and to a less extend DPP-4 inhibitors enhance insulin sensitivity. This review summarizes the current knowledge regarding the impact of GLP-1 analogues and DPP-4 inhibitors on insulin resistance.
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Laiko General Hospital, Athens University Medical School, Athens, Greece.
authors.forename: Pinelopi
authors.initials: P
authors.lastname: Grigoropoulou
authors.forename: Ioanna
authors.initials: I
authors.lastname: Eleftheriadou
authors.forename: Christos
authors.initials: C
authors.lastname: Zoupas
authors.forename: Evanthia
authors.initials: E
authors.lastname: Diamanti-Kandarakis
authors.forename: Nicholas
authors.initials: N
authors.lastname: Tentolouris
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D054795:Incretins / Q000494:pharmacology* / Q000627:therapeutic use*; D007333:Insulin Resistance
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D054795:Incretins; D052216:Glucagon-Like Peptide 1