Diabetes and Endocrinology, The Royal Surrey County Hospital & University of Surrey, Guildford, UK.
Clin Endocrinol (Oxf). 2012 Oct;77(4):489-99. doi: 10.1111/j.1365-2265.2012.04483.x.
The global burden of type 2 diabetes is growing. Traditional therapies are suboptimal and there is a clear unmet need for treatments that offer effective glucose control while addressing the comorbid factors associated with diabetes, such as obesity and risk of cardiovascular disease, without the fear of hypoglycaemia. Glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors offer a novel way of reducing hyperglycaemia by targeting the incretin system. This review provides an overview of the development of incretin-based therapies and explains their differing modes of action compared with traditional interventions. A comparison of the clinical profiles of current glucagon-like peptide-1 receptor agonists [liraglutide and exenatide (twice-daily and once-weekly)] and dipeptidyl peptidase-4 inhibitors (sitagliptin, saxagliptin, vildagliptin and linagliptin) is performed alongside a discussion of the placement of incretin-based therapies in treatment guidelines. Further improvements in this class are expected, and we will examine some of the novel glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors currently under development.
2 型糖尿病的全球负担正在增加。传统疗法并不理想，因此非常需要有效的降糖治疗药物，同时解决与糖尿病相关的合并症因素，如肥胖和心血管疾病风险，而又不担心低血糖。胰高血糖素样肽-1 受体激动剂和二肽基肽酶-4 抑制剂通过靶向肠促胰岛素系统提供了一种降低高血糖的新方法。本文综述了基于肠促胰岛素的治疗方法的发展，并解释了它们与传统干预措施相比的不同作用模式。本文还比较了目前的胰高血糖素样肽-1 受体激动剂（利拉鲁肽和艾塞那肽（每日两次和每周一次））和二肽基肽酶-4 抑制剂（西格列汀、沙格列汀、维格列汀和利格列汀）的临床特征，并讨论了基于肠促胰岛素的治疗方法在治疗指南中的定位。预计该类药物将进一步改善，我们将研究一些目前正在开发的新型胰高血糖素样肽-1 受体激动剂和二肽基肽酶-4 抑制剂。
