Incretin based therapy for Type 2 Diabetes Mellitus
Journal Title: The Indian Practitioner - Year 2014, Vol 67, Issue 9
Abstract
Type 2 Diabetes Mellitus (T2DM) is associated with obesity, insulin resistance, beta-cell dysfunction and hyperglucagonaemia, leading to hyperglycaemia. With the currently available antidiabetic agents, long term glycaemic control remains poor and attaining a glycosylated Hb (HbA1c) of < 7% is often not achievable. Further the antidiabetic agents available induce weight gain (except metformin), hypoglycaemia and have a negligible effect on beta-cell dysfunction. New classes of drugs that affect incretin hormones show promise in the treatment of T2DM. Incretins i.e. Glucagon-like peptide (GLP-1) and glucose-dependent insulinotropic peptides (GIP) are peptide hormones secreted from the gut in response to ingestion of food and enhance the glucose-stimulated insulin secretion from the pancreas. T2DM patients are resistant to the insulin secreting action of GIP but are responsive to GLP-1. Therefore, GLP-1 shows promise in the treatment of T2DM as it enhances glucose-stimulated insulin secretion and there are less chances of hypoglycaemia. In addition, it promotes insulin biosynthesis, suppresses glucagon secretion, improves fasting and post-prandial blood sugar, HbA1c, inhibits gastric emptying, reduces appetite and food intake. Further, GLP-1 has been found to prevent or reverse the destruction of β cells in preclinical studies and is also associated with beneficial effect on cardio-vascular risk factor including blood pressure (BP), weight, endothelial dysfunction and lipid profiles. The clinical use of GLP-1 is limited by its short t½ of 2 minutes, due to its degradation by the enzyme, dipeptidyl peptidase-4 (DPP-4). To combat this problem, drugs have been developed to increase the level of GLP-1 in the body i.e. GLP-1 receptor agonist (incretin mimetics) and DPP-4 inhibitors (incretin enhancers).
Authors and Affiliations
J Kaur, G Kwatra, DK Badyal
Keywords
Related Articles
- EP ID EP583418
- DOI -
- Views 50
- Downloads 0
Management of Snakebite – an Overview
It has been estimated that 5 million snakebites occur worldwide each year, causing about 125,000 deaths. Snakebites are more common in tropical regions and in areas that are primarily agricultural. Bites by venomous snak...
Burden of Chronic Suppurative Otitis Media in children of an underprivileged community of Delhi
Chronic Suppurative Otitis Media (CSOM) is a major cause of hearing impairment in developing countries and is the commonest cause of persistent mild to moderate hearing loss in children. In India, its prevalence varies f...
Entrapment of penis to suppress sexual stimulation by ball bearing device
Entrapment of penis is a rare condition, done to enhance penile erection. It presents a situation that challenges the surgeon to be innovative in selecting the treatment. This condition can cause vascular compromise, eve...
A Case Of Symptomatic Solitary Bifid Pedunculated Variant Of Osteochondroma In Young Female
Osteochondroma is a bony developmental anomaly with the potential to get a malignant transformation. It forms due to an outgrowth of growth plate which is made up of bone & cartilage. Mostly osteochondromas are asymptoma...
Colposcopic Evaluation of Patients with Abnormal Cervical Cytology and/or Unhealthy Cervix
Objectives: To assess the diagnostic accuracy, sensitivity and specificity of colposcopy in patients with abnormal cervical cytology and / or unhealthy cervix. Methods: Pap smear screening was done in 500 sexually activ...