Garber Alan J
Department ofMedicine, Biochemistry, and Molecular Biology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030-3411, USA.
J Am Osteopath Assoc. 2011 Jul;111(7 Suppl 5):S20-30.
As knowledge of pathophysiologic mechanisms of diabetes mellitus has increased, clinical attention has shifted to the incretin system. Incretin hormones, including glucagon-like peptide-1, or GLP-1, and glucose-dependent insulinotropic polypeptide, are vital to the control of glucose homeostasis and pancreatic β-cell preservation. Novel strategies for the treatment of patients with type 2 diabetes mellitus (T2DM) engage the incretin system. Glucagon-like peptide-1 receptor agonists provide robust glycemic control as well as beneficial reductions in body weight. Dipeptidyl peptidase-4, or DPP-4, inhibitors exhibit beneficial glycemic effects and are weight-neutral. Incretin-based medications are becoming increasingly recognized in guidelines as early treatment options because of their efficacy and well-tolerated profiles. The author reviews the safety and efficacy of currently approved incretin-based agents, as well as the role of these medications in treatment paradigms for patients with T2DM. He also discusses investigational incretin-based agents.
随着对糖尿病病理生理机制的认识不断增加，临床关注已转向肠促胰岛素系统。肠促胰岛素激素，包括胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽，对于控制葡萄糖稳态和胰腺β细胞保护至关重要。治疗2型糖尿病（T2DM）患者的新策略涉及肠促胰岛素系统。胰高血糖素样肽-1受体激动剂可提供强大的血糖控制以及体重的有益减轻。二肽基肽酶-4（DPP-4）抑制剂具有有益的血糖作用且对体重无影响。基于肠促胰岛素的药物因其疗效和良好的耐受性，在指南中越来越被认可为早期治疗选择。作者回顾了目前已批准的基于肠促胰岛素药物的安全性和有效性，以及这些药物在T2DM患者治疗模式中的作用。他还讨论了基于肠促胰岛素的研究性药物。
