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学科主题: 临床医学
题名:
The value of short- and long-acting glucagon-like peptide-1 agonists in the management of type 2 diabetes mellitus: experience with exenatide
作者: Guo, Xiao-Hui
关键词: Exenatide ; GLP-1 ; Glucagon-like peptide-1 ; Hyperglycemia ; Hypoglycemia ; Review ; Type 2 diabetes
刊名: CURRENT MEDICAL RESEARCH AND OPINION
发表日期: 2016-01-02
DOI: 10.1185/03007995.2015.1103214
卷: 32, 期:1, 页:61-76
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal ; Medicine, Research & Experimental
研究领域[WOS]: General & Internal Medicine ; Research & Experimental Medicine
关键词[WOS]: DEPENDENT INSULINOTROPIC POLYPEPTIDE ; METFORMIN-TREATED PATIENTS ; TWICE-DAILY EXENATIDE ; CARDIOVASCULAR RISK-FACTORS ; SUSTAINED GLYCEMIC CONTROL ; LABEL RANDOMIZED-TRIAL ; ONCE-WEEKLY EXENATIDE ; DRUG-NAIVE PATIENTS ; BETA-CELL FUNCTION ; PARALLEL-GROUP
英文摘要:

Background:

Only about half of patients with type 2 diabetes treated with antihyperglycemic drugs achieve glycemic control (HbA1c <7%), most commonly due to poor treatment adherence. Glucagon-like peptide-1 (GLP-1) receptor agonists act on multiple targets involved in glucose homeostasis and have a low risk of causing hypoglycemia. While GLP-1 receptor (GLP-1R) agonists share the same mechanism of action, clinical profiles of individual agents differ, particularly between short- and long-acting agents. In this article, recent findings regarding the pharmacology of GLP-1 agonists are reviewed, and the clinical effects of short- versus long-acting agents are compared.

Data sources:

Relevant articles were identified through a search of PubMed using the keywords glucagon-like peptide-1, GLP-1, glucagon-like peptide-1 receptor agonist, GLP-1R agonist, and exenatide for publications up to 22 May 2015. Supporting data were obtained from additional searches for albiglutide, dulaglutide, liraglutide and lixisenatide as well as from the bibliographies of key articles.

Findings:

Short-acting GLP-1R agonists produce greater reductions in postprandial glucose levels by slowing gastric emptying, whereas long-acting GLP-1R agonists produce greater reductions in fasting blood glucose by stimulating insulin secretion from the pancreas. These characteristics can be exploited to provide individualized treatment to patients. A large body of evidence supports the benefits of short- and long-acting exenatide as add-on therapy in patients with inadequate glycemic control despite maximum tolerated doses of metformin and/or sulfonylurea. Exenatide is generally well tolerated and no new safety concerns were identified during long-term follow-up of up to 5 years. A limitation of this review of short-and long-acting GLP-1 receptor agonists is that it focuses on exenatide rather than all the drugs in this class. However, the focus on a single molecule helps to avoid any confusion that may be introduced as a result of differences in molecular structure and size.

Conclusions:

Short-acting GLP-1R agonists including exenatide are well suited to patients with type 2 diabetes with exaggerated postprandial glucose excursions and for co-administration with basal insulin therapy. Long-acting GLP-1R agonists including once weekly exenatide offer greater convenience and are well suited to patients who require specific control of fasting hyperglycemia.

语种: 英语
项目资助者: AstraZeneca
WOS记录号: WOS:000367006100002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55094
Appears in Collections:北京大学第一临床医学院_内分泌内科_期刊论文

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作者单位: Peking Univ, Hosp 1, Dept Endocrinol, Beijing 100034, Peoples R China

Recommended Citation:
Guo, Xiao-Hui. The value of short- and long-acting glucagon-like peptide-1 agonists in the management of type 2 diabetes mellitus: experience with exenatide[J]. CURRENT MEDICAL RESEARCH AND OPINION,2016,32(1):61-76.
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