Nassar Mahmoud, Chaudhuri Ajay, Ghanim Husam, Dandona Paresh
Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY 14221, United States.
World J Diabetes. 2024 Feb 15;15(2):133-136. doi: 10.4239/wjd.v15.i2.133.
Type 1 diabetes (T1D) is a chronic autoimmune condition that destroys insulin-producing beta cells in the pancreas, leading to insulin deficiency and hyper-glycemia. The management of T1D primarily focuses on exogenous insulin replacement to control blood glucose levels. However, this approach does not address the underlying autoimmune process or prevent the progressive loss of beta cells. Recent research has explored the potential of glucagon-like peptide-1 receptor agonists (GLP-1RAs) as a novel intervention to modify the disease course and delay the onset of T1D. GLP-1RAs are medications initially developed for treating type 2 diabetes. They exert their effects by enhancing glucose-dependent insulin secretion, suppressing glucagon secretion, and slowing gastric emptying. Emerging evidence suggests that GLP-1RAs may also benefit the treatment of newly diagnosed patients with T1D. This article aims to highlight the potential of GLP-1RAs as an intervention to delay the onset of T1D, possibly through their potential immunomodulatory and anti-inflammatory effects and preservation of beta-cells. This article aims to explore the potential of shifting the paradigm of T1D management from reactive insulin replacement to proactive disease modification, which should open new avenues for preventing and treating T1D, improving the quality of life and long-term outcomes for individuals at risk of T1D.
1型糖尿病(T1D)是一种慢性自身免疫性疾病,它会破坏胰腺中产生胰岛素的β细胞,导致胰岛素缺乏和高血糖。T1D的管理主要集中在外源性胰岛素替代以控制血糖水平。然而,这种方法并未解决潜在的自身免疫过程,也无法阻止β细胞的逐渐丧失。最近的研究探索了胰高血糖素样肽-1受体激动剂(GLP-1RAs)作为一种新型干预措施来改变疾病进程并延缓T1D发病的潜力。GLP-1RAs最初是为治疗2型糖尿病而开发的药物。它们通过增强葡萄糖依赖性胰岛素分泌、抑制胰高血糖素分泌和减缓胃排空来发挥作用。新出现的证据表明,GLP-1RAs可能也有益于新诊断的T1D患者的治疗。本文旨在强调GLP-1RAs作为一种干预措施来延缓T1D发病的潜力,这可能是通过它们潜在的免疫调节和抗炎作用以及对β细胞的保护。本文旨在探索将T1D管理模式从反应性胰岛素替代转变为主动性疾病改善的潜力,这应该为预防和治疗T1D、改善T1D高危个体的生活质量和长期结局开辟新途径。