Department of Endocrinology, Shanghai Pudong Hospital, Fudan University, Shanghai 201399, China.
J Diabetes Res. 2020 Jun 16;2020:4727390. doi: 10.1155/2020/4727390. eCollection 2020.
Incretin-based therapy is now a prevalent treatment option for patients with type 2 diabetes mellitus (T2DM). It has been associated with considerably good results in the management of hyperglycemia with cardiac or nephron-benefits. For this reason, it is recommended for individuals with cardiovascular diseases in many clinical guidelines. As an incretin hormone, glucagon-like peptide-1 (GLP-1) possesses multiple metabolic benefits such as optimizing energy usage, maintaining body weight, cell preservation, and suppressing neurodegeneration. However, recent studies indicate that oral antidiabetic medications interact with endogenous or exogenous GLP-1. Since these drugs are transported to distal intestine portions, there are concerns whether these oral drugs directly stimulate intestinal L cells which release GLP-1, or whether they do so via indirect inhibition of the activity of dipeptidyl peptidase-IV (DPP-IV). In this review, we discuss the metabolic relationships between oral antihyperglycemic drugs from the aspect of gut, microbiota, hormones, cell function, central nervous system, and other cellular mechanisms.
基于肠促胰岛素的治疗方法目前是治疗 2 型糖尿病（T2DM）患者的流行治疗选择。它在管理高血糖症方面具有相当好的结果，具有心脏或肾单位益处。出于这个原因，它在许多临床指南中推荐用于心血管疾病患者。作为一种肠促胰岛素激素，胰高血糖素样肽-1（GLP-1）具有多种代谢益处，例如优化能量利用、保持体重、细胞保存和抑制神经退行性变。然而，最近的研究表明，口服抗糖尿病药物与内源性或外源性 GLP-1 相互作用。由于这些药物被运送到远端肠段，人们担心这些口服药物是否直接刺激释放 GLP-1 的肠 L 细胞，或者它们是否通过间接抑制二肽基肽酶-IV（DPP-IV）的活性来实现。在这篇综述中，我们从肠道、微生物群、激素、细胞功能、中枢神经系统和其他细胞机制方面讨论了口服降血糖药物之间的代谢关系。
