期刊
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
卷 70, 期 5, 页码 631-644出版社
WILEY
DOI: 10.1111/j.1365-2125.2010.03711.x
关键词
DPP-4; GLP-1; HbA1c; incretin; type 2 diabetes
资金
- National Institute for Health Research
- Sanofi Aventis
- Novo Nordisk UK Research Foundation
- Eli Lilly
- Servier Laboratories
- Takeda
- Merck Sharp Dohme
- Bristol Myers Squibb/Astra-Zeneca
- Roche
- GlaxoSmithKline
- Novo Nordisk
- Novartis
- National Institute for Health Research [RTF/01/094] Funding Source: researchfish
Type 2 diabetes mellitus (T2DM) is rapidly increasing in prevalence and is a major public health problem. It is a progressive disease which commonly requires multiple pharmacotherapy. Current options for treatment may have undesirable side effects (particularly weight gain and hypoglycaemia) and contraindications, and little effect on disease progression. Incretin based therapy is one of several newer therapies to improve glycaemia and is available in two different forms, dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) agonists. Use of these agents results in a 'glucose-dependant' increase in insulin secretion and glucagon suppression resulting in improved glycaemia with low incidence of hypoglycaemia. DPP-4 inhibitors are oral drugs which are weight neutral, while GLP-1 agonists are injected subcutaneously and help promote weight loss while improving glycaemia. GLP-1 agonists have also been shown to increase beta cell mass in rat models. Bariatric surgery is another option for the obese patient with T2DM, with blood glucose normalizing in over half of the patients following surgery. Other therapies in development for the treatment of T2DM include sodium-glucose transporter 2 (SGLT-2) inhibitors, glucagon receptor antagonists, glucokinase activators and sirtuins. In this article, we will review the various existing and emerging treatment options for T2DM.
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