GLP-1 for type 2 diabetes

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GLP-1 for type 2 diabetes. / Ahrén, Bo.

I: Experimental Cell Research, Vol. 317, Nr. 9, 2011, s. 1239-1245.

Forskningsoutput: TidskriftsbidragÖversiktsartikel

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Ahrén, Bo. / GLP-1 for type 2 diabetes. I: Experimental Cell Research. 2011 ; Vol. 317, Nr. 9. s. 1239-1245.

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TY - JOUR

T1 - GLP-1 for type 2 diabetes

AU - Ahrén, Bo

PY - 2011

Y1 - 2011

N2 - Glucagon-like peptide-1 (GLP-1)-based therapy of type 2 diabetes is executed either by GLP-1 receptor agonists, which stimulate the GLP-1 receptors, or by dipeptidyl peptidase-4 (DPP-4) inhibitors, which prevent the inactivation of endogenous GLP-1 thereby increasing the concentration of endogenous active GLP-1. GLP-1 activates pancreatic receptors resulting in improved glycemia through glucose-dependent stimulation of insulin secretion and inhibition of glucagon secretion. There is also a potential beta cell preservation effect, as judged from rodent studies. GLP-1 receptors are additionally expressed in extrapancreatic tissue, having potential for the treatment to reduce body weight and to potentially have beneficial cardio- and endothelioprotective effects. Clinical trials in subjects with type 2 diabetes have shown that in periods of 12 weeks or more, these treatments reduce HbA1c by approximate to 0.8-1.1% from baseline levels of 7.7-8.5%, and they are efficient both as monotherapy and in combination therapy with metformin, sulfonylureas, thiazolidinediones or insulin. Furthermore, GLP-1 receptor agonists reduce body weight, whereas DPP-4 inhibitors are body weight neutral. The treatment is safe with very low risk for adverse events, including hypoglycaemia. GLP-1 based therapy is thus a novel and now well established therapy of type 2 diabetes, with a particular value in combination with metformin in patients who are inadequately controlled by metformin alone. (C) 2011 Elsevier Inc. All rights reserved.

AB - Glucagon-like peptide-1 (GLP-1)-based therapy of type 2 diabetes is executed either by GLP-1 receptor agonists, which stimulate the GLP-1 receptors, or by dipeptidyl peptidase-4 (DPP-4) inhibitors, which prevent the inactivation of endogenous GLP-1 thereby increasing the concentration of endogenous active GLP-1. GLP-1 activates pancreatic receptors resulting in improved glycemia through glucose-dependent stimulation of insulin secretion and inhibition of glucagon secretion. There is also a potential beta cell preservation effect, as judged from rodent studies. GLP-1 receptors are additionally expressed in extrapancreatic tissue, having potential for the treatment to reduce body weight and to potentially have beneficial cardio- and endothelioprotective effects. Clinical trials in subjects with type 2 diabetes have shown that in periods of 12 weeks or more, these treatments reduce HbA1c by approximate to 0.8-1.1% from baseline levels of 7.7-8.5%, and they are efficient both as monotherapy and in combination therapy with metformin, sulfonylureas, thiazolidinediones or insulin. Furthermore, GLP-1 receptor agonists reduce body weight, whereas DPP-4 inhibitors are body weight neutral. The treatment is safe with very low risk for adverse events, including hypoglycaemia. GLP-1 based therapy is thus a novel and now well established therapy of type 2 diabetes, with a particular value in combination with metformin in patients who are inadequately controlled by metformin alone. (C) 2011 Elsevier Inc. All rights reserved.

KW - GLP-1

KW - DPP-4 inhibition

KW - Type 2 diabetes

KW - Exenatide

KW - Liraglutide

KW - Albiglutide

KW - Taspoglutide

KW - Lixisenatide

KW - Sitagliptin

KW - Vildagliptin

KW - Saxagliptin

KW - Alogliptin

KW - Linagliptin

U2 - 10.1016/j.yexcr.2011.01.010

DO - 10.1016/j.yexcr.2011.01.010

M3 - Review article

C2 - 21237153

VL - 317

SP - 1239

EP - 1245

JO - Experimental Cell Research

JF - Experimental Cell Research

SN - 1090-2422

IS - 9

ER -