Chahal H, Chowdhury T A
Department of Diabetes and Metabolism, The Royal London Hospital, UK.
QJM. 2007 Nov;100(11):671-7. doi: 10.1093/qjmed/hcm081. Epub 2007 Sep 19.
The epidemic of type 2 diabetes worldwide continues unabated. Despite a number of existing therapies, treatment goals are seldom fully achieved. While insulin resistance and beta cell failure remain important in the pathogenesis of the condition, the role of incretin hormones in glucose homeostasis has recently become clearer. Incretins have several glucoregulatory mechanisms, and a novel approach to the treatment of type 2 diabetes focuses on enhancing and prolonging the physiological actions of these hormones. Gliptins inhibit the enzyme dipeptidyl peptidase-IV (DPP-IV), which degrades incretin hormones. These drugs are a promising new class of oral hypoglycaemic medication, which appear to be weight-neutral and have few side-effects, although the published clinical studies are mainly regulatory licensing studies. As these drugs now are available for clinical use, we discuss the mechanism of action, efficacy and potential adverse effects of this new class of oral hypoglycaemic agent.
全球2型糖尿病的流行态势持续不减。尽管现有多种治疗方法,但治疗目标很少能完全实现。虽然胰岛素抵抗和β细胞功能衰竭在该疾病的发病机制中仍然很重要,但近年来肠促胰岛素激素在葡萄糖稳态中的作用已变得更加清晰。肠促胰岛素具有多种葡萄糖调节机制,一种治疗2型糖尿病的新方法聚焦于增强和延长这些激素的生理作用。格列汀类药物可抑制二肽基肽酶-IV(DPP-IV),该酶会降解肠促胰岛素激素。这些药物是一类很有前景的新型口服降糖药,似乎对体重没有影响且副作用较少,不过已发表的临床研究主要是监管许可研究。由于这些药物现已可供临床使用,我们将讨论这类新型口服降糖药的作用机制、疗效及潜在不良反应。
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