Potenza Matthew, Rayfield Elliot J
Mount Sinai School of Medicine, New York, NY, USA.
Mt Sinai J Med. 2009 Jun;76(3):244-56. doi: 10.1002/msj.20112.
The incretins have emerged as key targets in the modern treatment of type 2 diabetes mellitus. Understanding the physiology of the incretins is essential to the physician's ability to appropriately use emerging pharmacotherapies that target this system. This review describes incretin physiology and discusses recent trials of drugs that modulate this system in the treatment of type 2 diabetes. A MEDLINE search using the terms "GLP-1" (ie, glucagon-like peptide 1), "incretins," "exenatide," and "DPP-IV inhibitors" (ie, dipeptidyl peptidase IV inhibitors) was performed, and pertinent articles from the past 10 years were reviewed. Articles describing incretin physiology and clinical trials with exenatide and dipeptidyl peptidase IV inhibitors were identified and discussed. As the articles show, new medications manipulating the incretin system are an important part of treating type 2 diabetes. The cost of these drugs and their potential side effects in comparison with existing agents must be considered when they are being selected as part of a treatment regimen. However, the evidence to date offers much promise and enthusiasm.
肠促胰岛素已成为2型糖尿病现代治疗中的关键靶点。了解肠促胰岛素的生理学对于医生合理使用针对该系统的新兴药物治疗至关重要。本综述描述了肠促胰岛素的生理学，并讨论了近期调节该系统治疗2型糖尿病的药物试验。使用术语“GLP-1”（即胰高血糖素样肽1）、“肠促胰岛素”、“艾塞那肽”和“DPP-IV抑制剂”（即二肽基肽酶IV抑制剂）进行了MEDLINE检索，并对过去10年的相关文章进行了综述。确定并讨论了描述肠促胰岛素生理学以及艾塞那肽和二肽基肽酶IV抑制剂临床试验的文章。如文章所示，操纵肠促胰岛素系统的新药物是治疗2型糖尿病的重要组成部分。在将这些药物作为治疗方案的一部分进行选择时，必须考虑其成本以及与现有药物相比的潜在副作用。然而，迄今为止的证据带来了很大的希望和热情。
