title: [Characteristics and types of GLP-1 receptor agonists. An opportunity for individualized therapy].
abstract: Glucagon-like peptide 1 (GLP-1) is secreted from enteroendocrine L-cells in response to oral nutrient intake and elicits glucose-stimulated insulin secretion while suppressing glucagon secretion. Moreover slows gastric emptying -reducing postprandial glycemic excursions-, reduces body weight, systolic blood pressure and has beneficial effects in the cardiovascular and central nervous systems. Since the 1990s, the efficacy of GLP-1 in reducing blood glucose levels in type 2 diabetes (DM2) was well known. However, GLP-1 should be administered by chronic subcutaneous infusion because of the rapid cleavage by the enzyme dipeptidyl peptidase 4 (DPP-4). Hence, DPP-4 inhibitors -which increase pseudo-physiologically endogenous GLP-1 levels- were developed. In addition, several GLP-1 receptor agonists have been designed to avoid DPP-4-breakdown and/or rapid renal elimination and, therefore, induce a pharmacologic effect in the GLP-1 receptor: short-acting, long-acting, and prolonged-acting GLP-1 analogs. Each class has different structural, pharmacodynamic and clinical properties and could be administered in different therapeutical regimens giving us the opportunity to individualize the therapy of DM2.
authors.affiliation: Servicio de Endocrinología y Nutrición Clínica, Hospital Universitario Quirón Madrid, Facultad de Ciencias de la Salud, Universidad Europea de Madrid, Madrid, España. Electronic address: esteban.jodar@quiron.es.
authors.forename: Esteban
authors.initials: E
authors.lastname: Jódar
mesh_terms: D003692:Delayed-Action Preparations; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use; D004334:Drug Administration Schedule; D000067757:Glucagon-Like Peptide-1 Receptor / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D054795:Incretins / Q000627:therapeutic use*; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D003692:Delayed-Action Preparations; D054873:Dipeptidyl-Peptidase IV Inhibitors; D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D054795:Incretins; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: Agonistas del receptor de GLP-1; Análogos del GLP-1; DPP-4; Duración de efecto; Duration of effect; Efecto posprandial; Exendin-4; Exendina-4; GLP-1; GLP-1 analogs; GLP-1 receptor agonists; Individualización terapéutica; Individualization of drug therapy; Postprandial effect