Chon S, Riveline J-P, Blondeau B, Gautier J-F
Diabetes Metab. 2014 Dec;40(6):411-22. doi: 10.1016/j.diabet.2014.05.003.
Type 2 diabetes (T2D) is a complex, progressive disease with life-threatening complications and one of the most serious public-health problems worldwide. The two main mechanisms of T2D pathogenesis are pancreatic beta cell dysfunction and insulin resistance. It is now recognized that pancreatic beta cell dysfunction is a necessary factor for T2D development. Traditional therapies for controlling blood glucose are suboptimal as they fail to meet target goals for many patients. Glucagon-like peptide-1 receptor agonists (GLP1RA) and dipeptidyl peptidase-4 inhibitors (DPP4I) are an attractive class of therapy because they reduce blood glucose by targeting the incretin hormone system and, in particular, have the potential to positively affect pancreatic beta cell biology. This review outlines our current understanding of pancreatic beta cell incretin system dysfunction in T2D and summarizes recent evidence of the effect of incretin-based therapies on beta cell function and mass. Incretin-based therapies have shown strong evidence for beneficial effects on beta cell function and mass in animal studies. In humans, incretin-based therapies are effective glucose-lowering agents, but further study is still required to evaluate their long-term effects on beta cell function and safety as well as beta cell mass expansion.
2型糖尿病（T2D）是一种复杂的进行性疾病，伴有危及生命的并发症，是全球最严重的公共卫生问题之一。T2D发病机制的两个主要机制是胰腺β细胞功能障碍和胰岛素抵抗。现在人们认识到胰腺β细胞功能障碍是T2D发展的必要因素。传统的血糖控制疗法并不理想，因为它们无法满足许多患者的目标。胰高血糖素样肽-1受体激动剂（GLP1RA）和二肽基肽酶-4抑制剂（DPP4I）是一类有吸引力的疗法，因为它们通过靶向肠促胰岛素激素系统来降低血糖，特别是有可能对胰腺β细胞生物学产生积极影响。本综述概述了我们目前对T2D中胰腺β细胞肠促胰岛素系统功能障碍的理解，并总结了基于肠促胰岛素的疗法对β细胞功能和数量影响的最新证据。在动物研究中，基于肠促胰岛素的疗法已显示出对β细胞功能和数量有有益影响的有力证据。在人类中，基于肠促胰岛素的疗法是有效的降糖药物，但仍需要进一步研究来评估它们对β细胞功能和安全性以及β细胞数量增加的长期影响。
