Abstract:
:Current management options for treating type 2 diabetes are diverse. Many different classes of antidiabetes therapies are used in clinic, and several new candidates are in late-phase clinical trial. This therapeutic abundance is a windfall for patients because it facilitates individualized patient care. Evidence-based positioning of these agents is challenging, however, requiring comprehensive and balanced familiarity with each drug class. In this review, I provide a clinical update of glucagon-like peptide-1 receptor agonists (GLP-1RAs), a class of incretin-based, injectable antidiabetes therapies which improve fasting and postprandial blood glucose control through glucose-dependent pancreatic islet cell hormone secretion without significant risks for hypoglycemia. Chronic use of GLP-1RAs also promotes body weight loss through stimulation of GLP-1 receptors localized in hypothalamic satiety centres that regulate appetite, resulting in reduced caloric intake. Since 2005, when GLP-1RAs first received regulatory approval for type 2 diabetes, this class has expanded to include long-acting, once-weekly GLP-1RAs. Recent cardiovascular outcome trials demonstrate that long-term use of GLP-1RAs (liraglutide and semaglutide) reduce cardiovascular and renal complications of diabetes. Illustrating that GLP-1RAs are favourable in high-risk patients with type 2 diabetes. This review provides a clinical appraisal of the GLP-1RA class, highlighting intraclass similarities and differences, summarizing the clinical development of incretin-based diabetes therapies and focusing on currently approved GLP-1RAs. The review also discusses the implications of structural differences between GLP-1RA molecules and comments on the risks and benefits associated with GLP-1RAs and their positioning in treating type 2 diabetes.
journal_name
Can J Diabetesjournal_title
Canadian journal of diabetesauthors
Lovshin JAdoi
10.1016/j.jcjd.2017.08.242subject
Has Abstractpub_date
2017-10-01 00:00:00pages
524-535issue
5eissn
1499-2671issn
2352-3840pii
S1499-2671(17)30672-Xjournal_volume
41pub_type
杂志文章,评审abstract:OBJECTIVES:Although metformin has traditionally been avoided in pregnancy, evidence now supports its safety and efficacy for management of gestational diabetes mellitus (GDM). The primary objective of this study was to evaluate the clinical impact of a metformin-based approach for GDM management through assessment of p...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2019.06.005
更新日期:2019-12-01 00:00:00
abstract::Diabetes mellitus is one of the most common chronic diseases worldwide and a leading cause of morbidity and mortality. A high prevalence of type 2 diabetes mellitus has been noted among the South Asian population, in general, and migrant South Asians. Self-management is considered a proponent to the management of diab...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2019.04.010
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:The Goal Oriented controL of Diabetes in the Elderly populatioN (GOLDEN) Program assessed the management of older persons with type 2 diabetes in Canadian primary care. METHODS:Data were extracted from the records of 833 consecutively identified persons 65 years of age or older who had type 2 diabetes and we...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2017.03.003
更新日期:2018-02-01 00:00:00
abstract::Low grade inflammation has been linked to risk of type 2 diabetes and atherosclerotic vascular diseases. Obesity and, in particular, abdominal obesity increase the risk of diabetes and atherosclerotic vascular diseases. One of the mechanisms could be low grade inflammation and vascular endothelial dysfunction. Permane...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,评审
doi:10.1016/j.jcjd.2013.07.029
更新日期:2013-10-01 00:00:00
abstract::Whether consumption of omega-3 affects circulating adiponectin has not been established. The objective of this study was to evaluate the effect of omega-3 (food or supplement) on circulating adiponectin in patients with type 2 diabetes through a systematic review of meta-analyses of randomized controlled trials. PubMe...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,meta分析
doi:10.1016/j.jcjd.2017.12.002
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:The objective of the study was to describe the demographic and clinical characteristics of MedsCheck Diabetes (MCD) recipients in Ontario between program launch on September 1, 2010, and March 31, 2014. METHODS:This cohort study leveraged linked administrative claims data. Trends in MCD claims and recipient...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2016.12.001
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVES:South Asian immigrants are generally healthy upon arrival, but precipitously develop diabetes after immigration. Whether cultural and psychosocial factors contribute to diabetes risk in this ethnic minority group remains unclear. Existing prediction models focus primarily on clinical and lifestyle factors. T...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2019.04.015
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:Physicians lack clear guidance about adaptation of clinical practice guidelines for elderly institutionalized patients with diabetes. In a large long-term care facility, a diabetes management flow sheet was trialed to determine which clinical parameters were found useful by clinicians in the management of di...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2014.12.001
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVES:Our purpose was to disseminate and implement the Diabetes Canada (formerly the Canadian Diabetes Association) 2013 Clinical Practice Guidelines and evaluate the impact of the dissemination and implementation strategy on process outcomes (reach, adoption, implementation and maintenance). METHODS:Our patient-...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2018.08.189
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVES:To investigate the support needs of elderly patients with diabetes and to classify elderly patients with diabetes living alone on the basis of support needs. METHODS:Support needs were derived from a literature review of relevant journals and interviews of outpatients as well as expert nurses in the field o...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcjd.2015.09.005
更新日期:2016-02-01 00:00:00
abstract::The importance of glycemic control in hospitalized patients has been a relatively recent revelation. There is somewhat contradictory evidence concerning the optimal glycemic target in critically ill patients. There is only indirect evidence in non-critically ill patients. This article reviews the evidence for glycemic...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,评审
doi:10.1016/j.jcjd.2014.01.001
更新日期:2014-04-01 00:00:00
abstract::Dietary modifications play a central role in the treatment of diabetes. Educating and empowering individuals to make better dietary choices is a challenging task. In this context, 1 potential dietetic approach to achieve better glycemic control in type 2 diabetes is often overlooked: the use of short-term dietary oatm...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2019.08.020
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVES:Diabetes frequently coexists with other conditions, resulting in poorer diabetes self-management and quality of life, higher risk for diabetes-related complications and higher health service use compared to those with diabetes only. Few Canadian studies have undertaken a comprehensive, population-level analy...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2015.09.002
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:We aimed to build a risk score model to screen out the patients at high-risk status so as to prevent or delay the conversion of prediabetes to diabetes. METHODS:The population were divided into 2 groups: 1 was an exploratory population, and the other was a validation population. All the data were extracted ...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2016.02.013
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:This study aimed to describe the risk of developing diabetes and the probable prevalence of diabetes and prediabetes in residents of subsidized or social housing who were 55 years of age or older. METHODS:We conducted a cross-sectional study using data collected from an ongoing community health program in s...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2020.10.005
更新日期:2020-10-16 00:00:00
abstract:OBJECTIVE:This article describes a qualitative research study that examines the encounters by patients of low socioeconomic status with a group medical visit (GMV) program for individuals with or at risk for diabetes. The goal of this study was to generate insights that could be used to guide the development of an inne...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2014.03.012
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To explore perspectives on the meaning of health to Aboriginal adults and youth living in a northern Manitoba First Nations community. METHODS:Six focus groups with 29 youth and individual interviews with 10 adults were audio-recorded, transcribed verbatim and thematically analyzed. RESULTS:Adults and older...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/S1499-2671(08)22008-3
更新日期:2008-01-01 00:00:00
abstract::Brain-derived neurotrophic factor (BDNF), a member of neurotrophin growth factor family, physiologically mediates induction of neurogenesis and neuronal differentiation, promotes neuronal growth and survival and maintains synaptic plasticity and neuronal interconnections. Unlike the central nervous system, its secreti...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,评审
doi:10.1016/j.jcjd.2016.08.228
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Fenugreek and its active compound diosgenin are ancient herbal medicines recommended by the World Health Organization. In this study, the effect of diosgenin on changes in carbohydrate metabolic enzymes and glycogen content in muscle and kidneys of streptozotocin-induced diabetes rats were evaluated. METHODS...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2014.02.004
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:As part of a larger project to develop quality standards in perioperative diabetes management, the goal of this project was to assess self-reported management of surgical patients with diabetes across healthcare institutions and specialties in Canada. METHODS:Current practice of perioperative management of p...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2020.10.011
更新日期:2020-10-27 00:00:00
abstract:OBJECTIVES:1) to describe current utilization of e-mail in the clinical care of patients with diabetes; and 2) to identify barriers to and facilitators of the adoption of e-mail in diabetes care. METHODS:Participants included diabetes care providers, including 9 physicians and 7 allied health professionals (AHPs). Par...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2015.07.001
更新日期:2015-12-01 00:00:00
abstract::Cerebral edema (CE) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA) in children with type 1 diabetes. CE is frequently mentioned as being more common in young children. The primary objective of this study was to review the evidence suggesting that younger age is a risk factor for the develo...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,评审
doi:10.1016/j.jcjd.2019.04.013
更新日期:2020-02-01 00:00:00
abstract::The prevalence of chronic metabolic diseases, such as diabetes, cardiovascular diseases and cancer, is increasing around the world. Nutritional interventions can reduce the prevalence and provide effective treatment, even when weight loss is not dramatic. The 2013 Canadian Diabetes Association Clinical Practice Guidel...
journal_title:Canadian journal of diabetes
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.jcjd.2016.05.005
更新日期:2016-08-01 00:00:00
abstract::Epidemiological studies suggest that adults and children who are habitual short sleepers tend to have a higher body mass index, fat percentage and abdominal circumference when compared to average-duration sleepers. Reduced or disturbed sleep is also associated with certain predictors of type 2 diabetes, such as glucos...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,评审
doi:10.1016/j.jcjd.2013.02.060
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:Hypokalemia, a frequently cited complication of diabetic ketoacidosis (DKA) treatment, can have critical implications, including arrhythmias and death. We assessed the prevalence of hypokalemia and its associated factors in patients with DKA at our tertiary-care centre and identified opportunities to improve...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2015.10.002
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:(1) to describe pediatric patients with T1D and their caregivers' perceptions of measures of glycemic control (hemoglobin [A1C] and blood glucose [BG] levels) and (2) to determine the relationship between patients' and caregivers' perceptions of measures of glycemic control with actual A1C levels and adheren...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2017.07.002
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes. METHODS:Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcjd.2016.08.223
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:It was uncertain whether an algorithm that involves increasing insulin dosages by 1 unit/day may cause more hypoglycemia with the longer-acting insulin glargine 300 units/mL (GLA-300). The objective of this study was to compare safety and efficacy of 2 titration algorithms, INSIGHT and EDITION, for GLA-300 in...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jcjd.2017.06.007
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether perinatal outcomes differ between Caucasian and Asian subgroups of women with gestational diabetes mellitus (GDM) through use of standard vs ethnicity-specific birthweight curves. METHODS:This retrospective cohort study included 537 women with GDM, within the et...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2019.06.006
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To describe the use patterns of metformin-based antidiabetic regimens in patients with type 2 diabetes and to identify predictors of initiating metformin monotherapy. METHODS:By using administrative databases from Alberta, Canada, we identified all metformin users ages 65 years and older between 1998 and 201...
journal_title:Canadian journal of diabetes
pub_type: 杂志文章
doi:10.1016/j.jcjd.2013.04.008
更新日期:2013-12-01 00:00:00