Yabe Daisuke, Seino Yutaka
a Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan.
b Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka, Japan.
Expert Rev Endocrinol Metab. 2014 Nov;9(6):659-670. doi: 10.1586/17446651.2014.949672. Epub 2014 Sep 3.
With the advent of dipeptidyl peptidase (DPP)-4 inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) over the past decade, incretin therapy has become established as an important treatment strategy for Type 2 diabetes mellitus (T2DM), with an efficacy and safety profile distinct from that of other anti-hyperglycemic agents. However, our understanding of the optimal clinical use of incretins remains incomplete. This review focuses on the use of GLP-1 RAs in the treatment of T2DM, with reference to the differing dominant mechanisms of action between short- and long-acting GLP-1 RAs and the clinical implications of this difference. The role of GLP-1 and the effects of GLP-1 RAs in various organs other than the pancreas will also be discussed.
在过去十年中,随着二肽基肽酶(DPP)-4抑制剂和胰高血糖素样肽-1受体激动剂(GLP-1 RAs)的出现,肠促胰岛素疗法已成为2型糖尿病(T2DM)的重要治疗策略,其疗效和安全性与其他降糖药物不同。然而,我们对肠促胰岛素最佳临床应用的理解仍不完整。本综述重点关注GLP-1 RAs在T2DM治疗中的应用,并参考短效和长效GLP-1 RAs不同的主要作用机制以及这种差异的临床意义。还将讨论GLP-1的作用以及GLP-1 RAs在胰腺以外的各种器官中的作用。