Effects of chronic treatment with metformin on dipeptidyl peptidase-4 activity, glucagon-like peptide 1 and ghrelin in obese patients with Type 2 diabetes mellitus

2012 ◽  
Vol 29 (8) ◽  
pp. e205-e210 ◽  
Author(s):  
S. K. Thondam ◽  
A. Cross ◽  
D. J. Cuthbertson ◽  
J. P. Wilding ◽  
C. Daousi
2021 ◽  
Vol 11 (5) ◽  

Dipeptidyl peptidase IV is a key regulator of insulin- stimulating hormones, glucagon-like peptide and glucose dependent insulinotrophic polypeptide. Thus it is a promising target for treatment of type 2 Diabetes mellitus. Inhibition of plasma Dipeptidyl peptidase IV enzyme lead to enhanced endogenous glucagon like peptide-1, GIP activity which ultimately results in the potentiating of insulin secretion by pancreatic cell and subsequent lowering blood glucose level, HbA [1c], glucose secretion, liver glucose production. One of the principal goals of diabetes management is to attain haemoglobin HbA [1c] treatment goals and prevent the onset or decrease the rate of occurrence of Microvascular conditions.2, 6 numerous treatment options are available for management of Type 2 Diabetes mellitus, various class of DPP IV inhibitor being explored such as Sitagliptin and Vildagliptin successfully launched. Several other novel DPP IV inhibitors are in pipeline, Unless there are clear contraindications, metformin monotherapy is prescribed, and if HbA [1c] targets are not attained after 3 months, 1 of several classes of agents could be added, such as sulfonylurea’s, Thiazolidinediones, dipeptidyl peptidase-4 inhibitors, - glucagon like peptide-1 receptor agonists, or basal insulin.2,6 Despite the broad range of therapeutic options, the attainment of HbA [1c] goals among patients with diabetes remains challenging, with just slightly more than half (52%) of diabetes patients attaining the common HbA [1c] goal of < 7.0%. The present review summarizes latest preclinical and clinical trial data of different DPP IV inhibitors with a special emphasis on their DPP8/9 fold selectivity and therapeutic advantages over GLP-1 based approach. Keywords: Diabetes 2, Dipeptidyl Peptidase-4, glucose-dependent insulinot


2012 ◽  
Vol 15 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Yury Ivanovich Suntsov

Aims. To conduct an analysis of modern antihyperglycemic prescription patterns in type 2 diabetes mellitus (T2DM). Materials and methods. Russian DM State registry was studied. Results. We obtained absolute and comparative data on use of insulin analogues, dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 agonists in treatment of T2DM. Conclusion. Percentage of DPP-4 inhibitors and GLP-1 analogues in T2DM treatment patterns remains nominal and does not exceed0.2%, which is significantly lower than in the majority of other countries. Insulin analogues are prescribed considerably more frequentlyand currently appear to be the most promising agents for treatment of T2DM.


2016 ◽  
Vol 12 (1) ◽  
pp. 28-32
Author(s):  
Lokendra Bahadur Sapkota ◽  
Sangita Thapa

Background & Objectives: Type 2 diabetes mellitus (T2DM) is a progressive disease, characterized by insulin resistance, impaired glucose-induced insulin secretion, inappropriately elevated glucagon concentrations, and hyperglycemia. Many patients cannot obtain satisfactory glycemic control with current therapies. New and more effective agents, targeted not only at treatment, but also at prevention of the disease, its progression, and its associated complications, are, therefore, required. The dipeptidyl peptidase-4 (DPP-4) inhibitors are a newer class of oral drugs for the treatment of T2DM. They inhibit the breakdown of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) thereby increasing the incretin effect in patients with T2DM. In clinical practice they are associated with significant reductions in HbA1c, no weight gain and a low risk of hypoglycemia. Since incretin response is markedly diminished in Asian populations, these agents can be used to achieve satisfactory glycemic control in Nepalese T2DM patients.JCMS Nepal. 2016;12(1):28-32.


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