Frias Juan P, Edelman Steven V
Animas Corp., West Chester, Pennsylvania 19380, USA.
Curr Opin Endocrinol Diabetes Obes. 2007 Aug;14(4):269-76. doi: 10.1097/MED.0b013e32825ea2ba.
To review data from clinical trials of incretin mimetics in patients with type 2 diabetes.
Incretin mimetics are a new class of antidiabetic medication that mimic the actions of the hormone glucagon-like peptide-1. They exhibit several properties, including glucose-dependent stimulation of insulin secretion, suppression of glucagon secretion, slowing of gastric emptying and induction of satiety, which result in improvements in glycemic control with weight loss in patients with type 2 diabetes. Recent 2-year data with exenatide, the only commercially available incretin mimetic, have demonstrated long-term sustained reductions in hemoglobin A1c with progressive weight loss. Glycemic and weight benefits were also recently reported in a 15-week study assessing once-weekly administration of long-acting release exenatide, a formulation currently in phase 3 of clinical development. Once-daily administration of liraglutide, also in phase 3 of development, has recently been shown to improve glycemic and weigh control as monotherapy, and in combination with metformin. The most common side effects of incretin mimetics are gastrointestinal in nature, particularly nausea.
The ability of incretin mimetics to improve glycemic control and reduce body weight is a unique property that fills an important void in the treatment of patients with type 2 diabetes.
回顾2型糖尿病患者使用肠促胰岛素类似物的临床试验数据。
肠促胰岛素类似物是一类新型抗糖尿病药物，可模拟激素胰高血糖素样肽-1的作用。它们具有多种特性，包括葡萄糖依赖性刺激胰岛素分泌、抑制胰高血糖素分泌、减缓胃排空和诱导饱腹感，从而改善2型糖尿病患者的血糖控制并减轻体重。唯一可商购的肠促胰岛素类似物艾塞那肽的最新2年数据显示，糖化血红蛋白长期持续降低，体重逐渐减轻。最近一项为期15周的研究报告了血糖和体重方面的益处，该研究评估了长效释放艾塞那肽每周一次的给药情况，该制剂目前处于临床开发的3期。同样处于3期开发阶段的利拉鲁肽每日一次给药，最近已显示作为单一疗法以及与二甲双胍联合使用时可改善血糖和体重控制。肠促胰岛素类似物最常见的副作用本质上是胃肠道方面的，尤其是恶心。
肠促胰岛素类似物改善血糖控制和减轻体重的能力是一项独特的特性，填补了2型糖尿病患者治疗中的一个重要空白。
