Incretins: what is known, new and controversial in 2013?

Abstract:

:Glucagon-like peptide (GLP)-1 action involves both endocrine and neural pathways to control peripheral tissues. In diabetes the impairment of either pathway may define different subsets of patients: some may be better treated with GLP-1 receptor agonists that are more likely to directly stimulate beta-cells and extrapancreatic receptors, while others may benefit from dipeptidyl peptidase (DPP)-4 inhibitor treatments that are more likely to increase the neural gut-brain-pancreas axis. Elevated plasma concentrations of GLP-1 associated with agonist treatment or bariatric surgery also appear to exert neuroprotective effects, ameliorate postprandial and fasting lipids, improve heart physiology and protect against heart failure, thereby expanding the possible positioning of GLP-1-based therapies. However, the mechanisms behind GLP-1 secretion, the role played by proximal and distal intestinal GLP-1-producing cells as well as the molecular basis of GLP-1 resistance in diabetes are still to be ascertained. The pharmacological features distinguishing GLP-1 receptor agonists from DPP-4 inhibitors are discussed here to address their respective positions in type 2 diabetes.

journal_name

Diabetes Metab

journal_title

Diabetes & metabolism

authors

Burcelin R,Thorens B,European Club for the study of GLP-1 (EuCSGLP-1).

doi

10.1016/j.diabet.2013.02.005

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

89-93

issue

2

eissn

1262-3636

issn

1878-1780

pii

S1262-3636(13)00040-2

journal_volume

39

pub_type

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