4.1 Article

Contemporary Updates on the Physiology of Glucagon like Peptide-1 and Its Agonist to Treat Type 2 Diabetes Mellitus

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SPRINGER
DOI: 10.1007/s10989-019-09927-y

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Incretin; GLP-1; GLP-1 agonist; Incretin mimetics; Diabetes mellitus; Insulin; Hypoglycaemia

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Pathogenesis of diabetes mellitus involves scores of different factors, out of which Glucagon like factor-1 (GLP-1) plays a foremost role. GLP-1 is a peptide-hormone of the incretin system. It exhibits glucagonostatic as well as glucose dependent insulinotropic action. GLP-1 augments regeneration of beta-cell, boost secretion of insulin and trim down weight gain in type-2 diabetes. GLP-1 discharge from the L cells of intestine is mediated by neural and hormonal factors which are stimulated by the occurrence of nutrients in the gastrointestinal tract. Conversely, GLP-1 is instantaneously shattered by enzyme dipeptidyl peptidase-IV. GLP-1 is also cleared by renal clearance. Diminished GLP-1 leads to attenuated insulin release leading to type-2 diabetes. Substitution of GLP-1 regularizes the insulin release and prevents type-2 diabetes. However, GLP-1 holding infinitesimal plasma half life limits its therapeutic effects. To surmount the limitations of indigenous GLP-1, several GLP-1 receptor agonist like Exenatide are been developed. Modifications in pharmaceutical formulation are also been made to meet the patients adherence to the medication of GLP-1 agonist. Graphic

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