Department of Internal Medicine, San Raffaele Scientific Institute and Vita Salute San Raffaele University, 20132 Milan, Italy.
J Clin Endocrinol Metab. 2010 Jun;95(6):2607-9. doi: 10.1210/jc.2009-2741.
Incretin-based compounds, including glucagon-like peptide-1 receptor agonists and dipeptidyl-peptidase-4 inhibitors, have emerged as a new class of agents for the treatment of type 2 diabetes. In this article, the potential and supporting evidence for extending their use to early type 1 diabetes are reviewed. The rationale relies on the assumption that these drugs, in addition to their action on insulin secretion and glucose regulation, may be effective in preserving and even expanding the beta-cell mass. This assumption is based on data from in vitro and animal studies, with no clear demonstrations in humans. This class of drugs may represent an entirely new approach to the treatment of type 1 diabetes, focused on protection and preservation of beta-cells, an ideal complement to immune interventions inhibiting or modulating the pathogenetic autoimmune process. The ideal candidates for this treatment are patients at the time of clinical onset of type 1 diabetes or individuals with preclinical type 1 diabetes who still have a significant viable beta-cell mass.
基于肠降血糖素的化合物，包括胰高血糖素样肽-1 受体激动剂和二肽基肽酶-4 抑制剂，已成为治疗 2 型糖尿病的一类新型药物。本文综述了将其用途扩展到早期 1 型糖尿病的潜力和支持证据。其基本原理基于这样一种假设，即除了对胰岛素分泌和血糖调节的作用外，这些药物还可能在保护甚至扩大β细胞质量方面有效。这一假设基于体外和动物研究的数据，而在人类中尚无明确的证据。这类药物可能代表了治疗 1 型糖尿病的一种全新方法，侧重于保护和保存β细胞，这是抑制或调节致病自身免疫过程的免疫干预的理想补充。这种治疗的理想候选者是在 1 型糖尿病临床发病时或仍有大量存活β细胞的临床前 1 型糖尿病个体。
