Funnell Martha M
Michigan Diabetes Research and Training Center, Ann Arbor, Michigan 48109-0489, USA.
Diabetes Educ. 2009 Jan-Feb;35 Suppl 1:12S-7S. doi: 10.1177/0145721709331521.
Gastric inhibitory peptide (GIP) and glucagon-like peptide-1 (GLP-1) stimulate the secretion of insulin when blood glucose levels are elevated and inhibit the postprandial release of glucagon. An increased understanding of the role of these incretin hormones in insulin and blood glucose regulation has resulted in the development of new types of medications for managing diabetes. GLP-1 agonists and dipeptidyl peptidase-IV (DPP-4) inhibitors are 2 classes of medications that have been shown to offer benefits for patients with type 2 diabetes. To use and teach patients how to use these medications effectively, educators need to understand their mechanisms of action, indications and contraindications, side effects, and effectiveness. Expanding the number of options available has increased the complexity of providing care and education, but also offers new opportunities to help our patients achieve better outcomes.
This article provides an overview of the physiology of insulin regulation and the roles of GIP, GLP-1, and DPP-4; discusses how the action of incretin hormones is affected by diabetes; and describes the therapeutic agents in these classes and their potential use by people with diabetes.
血糖水平升高时，胃抑制肽（GIP）和胰高血糖素样肽-1（GLP-1）可刺激胰岛素分泌，并抑制餐后胰高血糖素释放。对这些肠促胰岛素激素在胰岛素和血糖调节中作用的深入了解，促使了新型糖尿病治疗药物的研发。GLP-1激动剂和二肽基肽酶-IV（DPP-4）抑制剂是已被证明对2型糖尿病患者有益的两类药物。为了使用并指导患者有效使用这些药物，教育工作者需要了解其作用机制、适应证和禁忌证、副作用以及疗效。可用药物选择的增加虽然增加了提供护理和教育的复杂性，但也为帮助我们的患者取得更好的治疗效果提供了新机会。
本文概述了胰岛素调节的生理学以及GIP、GLP-1和DPP-4的作用；讨论了糖尿病如何影响肠促胰岛素激素的作用；并描述了这些类别的治疗药物及其在糖尿病患者中的潜在用途。
