Medizinische Klinik IV, Otfried-Müller-Strasse 10, 72076, Tübingen, Germany.
Pediatr Nephrol. 2010 Jul;25(7):1207-17. doi: 10.1007/s00467-009-1435-z. Epub 2010 Feb 4.
Treatment options for type 2 diabetes based on the action of the incretin hormone glucagon-like peptide-1 (GLP-1) were first introduced in 2005. These comprise the injectable GLP-1 receptor agonists solely acting on the GLP-1 receptor on the one hand and orally active dipeptidyl-peptidase inhibitors (DPP-4 inhibitors) raising endogenous GLP-1 and other hormone levels by inhibiting the degrading enzyme DPP-4. In adult medicine, both treatment options are attractive and more commonly used because of their action and safety profile. The incretin-based therapies stimulate insulin secretion and inhibit glucagon secretion in a glucose-dependent manner and carry no intrinsic risk of hypoglycaemia. GLP-1 receptor agonists allow weight loss, whereas DPP-4 inhibitors are weight neutral. This review gives an overview of the mechanism of action and the substances and clinical data available.
2005 年首次引入了基于胰高血糖素样肽-1(GLP-1)作用的 2 型糖尿病治疗选择。这些治疗方法包括一方面仅作用于 GLP-1 受体的可注射 GLP-1 受体激动剂,以及另一方面通过抑制降解酶 DPP-4 来提高内源性 GLP-1 和其他激素水平的口服二肽基肽酶抑制剂(DPP-4 抑制剂)。在成人医学中,由于其作用和安全性,这两种治疗选择都很有吸引力,并且更常用。基于肠促胰岛素的治疗方法以葡萄糖依赖性方式刺激胰岛素分泌并抑制胰高血糖素分泌,并且没有低血糖的内在风险。GLP-1 受体激动剂可减轻体重,而 DPP-4 抑制剂则不影响体重。本文综述了作用机制以及现有物质和临床数据。