scholarly journals Incretin-Based Therapies Role in COVID-19 Era: Evolving Insights

2020 ◽  
Vol 25 (6) ◽  
pp. 494-496
Author(s):  
Anca Pantea Stoian ◽  
Nikolaos Papanas ◽  
Martin Prazny ◽  
Ali A. Rizvi ◽  
Manfredi Rizzo
Keyword(s):  
Scientific Community ◽  
Clinical Course ◽  
Mechanisms Of Action ◽  
Disease Pathogenesis ◽  
Prognostic Variables ◽  
Dipeptidyl Peptidase 4 ◽  
Treatment Regimens ◽  
Antidiabetic Treatment ◽  
Coronavirus Infection

The current coronavirus disease 2019 (COVID-19) pandemic has led the scientific community to breach new frontiers in the understanding of human physiology and disease pathogenesis. It has been hypothesized that the human dipeptidyl peptidase 4 (DPP4) enzyme receptor may be a functional target for the spike proteins of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Since DPP4-inhibitors are currently used for the treatment of patients with type-2 diabetes (T2DM), there is currently high interest in the possibility that these agents, or incretin-based therapies (IBTs) in general, may be of benefit against the new coronavirus infection. Diabetes is associated with increased COVID-19 severity and mortality, and accumulating evidence suggests that IBTs may favorably alter the clinical course of SARS-CoV-2 infection due to their inherent mechanisms of action. Further research into prognostic variables associated with various antidiabetic treatment regimens, and in particular the IBT, in patients with T2DM affected by the COVID-19 pandemic is therefore warranted.

scholarly journals Saxagliptin and Metformin in Fixed Combination for the Treatment of Type 2 Diabetes in Adults

2013 ◽  
Vol 6 ◽  
pp. CMED.S8510
Author(s):  
Molly G. Minze ◽  
Mary S. Klein ◽  
Brian T. Terrell
Keyword(s):  
Type 2 Diabetes ◽  
First Line ◽  
Dipeptidyl Peptidase 4 ◽  
Treatment Regimens ◽  
Patient Satisfaction Scores ◽  
Dipeptidyl Peptidase 4 Inhibitor ◽  
Attractive Option ◽  
Secondary Mechanism ◽  
Current Guidelines

Type 2 diabetes affects millions of people worldwide and significantly contributes to morbidity and mortality of those affected by it. Current guidelines recommend individualized treatment regimens following first line metformin therapy. Saxagliptin, a dipeptidyl-peptidase 4 inhibitor, provides a secondary mechanism of action to decrease hyperglycemia when used in combination with metformin. The combination of metformin and saxagliptin has shown improvements in hemoglobin A1c and fasting plasma glucose in greater efficacy than when either agent is used alone. Adverse effects of combination therapy are similar to when these agents are used individually, and are rated as tolerable by patient satisfaction scores. Overall, the combination use of saxagliptin in addition to metformin is an attractive option for clinicians to use in the treatment of type 2 diabetes.

Sulfonylureas in today’s blood glucose lowering therapy.New data on advantages and potential barriers of an “old” antidiabetic group

2015 ◽  
Vol 156 (13) ◽  
pp. 511-515
Author(s):  
Gábor Winkler
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Sulfonylurea Compounds ◽  
Drug Of Choice ◽  
Antidiabetic Treatment ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Glucose Lowering Therapy

Sulfonylurea compounds have been basic elements of antidiabetic treatment in type 2 diabetes for a long time. However, with the introduction of incretin type insulin secretagogues it is often arises, whether is still there a place for sulfonylureas in the today’s therapy. To answer this question the author overviews general pharmaceutical characteristics of the sulfonylurea compounds as well as individual particularities of the second generation derivatives used at present in Hungary. The author details also the most important differences between incretin type drugs − first of all dipeptidyl peptidase-4 inhibitors − and sulfonylureas. On the basis of available data it can be concluded in accordance with the latest international guidelines, that sulfonylureas have still role in the blood glucose lowering therapy of type 2 diabetes, though they became somewhat pushed back among insulin secretagogue type drugs. If a sulfonylurea compound is the drug of choice, it is important to select the appropriate molecule (in case of normal renal function gliclazide or glimepiride). It is also important to re-educate the patient, as well as to apply the minimal dose providing the desired glycaemic effect. Orv. Hetil., 2015, 156(13), 511–515.

scholarly journals Coronavirus Infections and Type 2 Diabetes—Shared Pathways with Therapeutic Implications

2020 ◽  
Vol 41 (3) ◽  
pp. 457-470 ◽  
Author(s):  
Daniel J Drucker
Keyword(s):  
Type 2 Diabetes ◽  
Viral Infections ◽  
Biological Activities ◽  
Angiotensin Converting Enzyme 2 ◽  
Dipeptidyl Peptidase 4 ◽  
Therapeutic Implications ◽  
Increased Risk ◽  
Coronavirus Infection ◽  
Coronavirus Infections

Abstract Abstract Individuals with diabetes are at increased risk for bacterial, mycotic, parasitic, and viral infections. The severe acute respiratory syndrome (SARS)-CoV-2 (also referred to as COVID-19) coronavirus pandemic highlights the importance of understanding shared disease pathophysiology potentially informing therapeutic choices in individuals with type 2 diabetes (T2D). Two coronavirus receptor proteins, angiotensin-converting enzyme 2 (ACE2) and dipeptidyl peptidase-4 (DPP4) are also established transducers of metabolic signals and pathways regulating inflammation, renal and cardiovascular physiology, and glucose homeostasis. Moreover, glucose-lowering agents such as the DPP4 inhibitors, widely used in subjects with T2D, are known to modify the biological activities of multiple immunomodulatory substrates. Here, we review the basic and clinical science spanning the intersections of diabetes, coronavirus infections, ACE2, and DPP4 biology, highlighting clinical relevance and evolving areas of uncertainty underlying the pathophysiology and treatment of T2D in the context of coronavirus infection.

scholarly journals Impact of Glucose-Lowering Medications on Cardiometabolic Risk in Type 2 Diabetes

2019 ◽  
Author(s):  
Angelo Maria Patti ◽  
Ali A Rizvi ◽  
Rosaria Vincenza Giglio ◽  
Anca Pantea Stoian ◽  
Daniela Ligi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Subclinical Atherosclerosis ◽  
Macrophage Polarization ◽  
Vascular Complications ◽  
Rapid Progression ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Antidiabetic Treatment ◽  
Dipeptidyl Peptidase 4 Inhibitors

Type 2 Diabetes Mellitus (T2DM) is associated with a high risk of atherosclerotic cardiovascular (CV) disease. Contributing pathophysiologic factors include endothelial dysfunction caused by excessive production of reactive oxygen species (ROS), increased activity of nuclear factor kB (NFkB), altered macrophage polarization, and reduced synthesis of endothelial progenitor cells (EPC). Consequently, there can be a potentially rapid progression of the atherosclerotic disease with a higher propensity to unstable plaque, leading to increased cardiovascular mortality. Management is aimed at prevention, early diagnosis, and treatment of hyperglycemia and vascular complications. Innovative therapeutic approaches for T2DM seek to customize the antidiabetic treatment to each patient in order to optimize glucose-lowering effects, minimize hypoglycemia and adverse effects, and prevent cardiovascular events. The newer drugs (Glucagon Like Peptide-1 Receptor Agonists, GLP-1 RAs; Sodium GLucose coTransporter-2 inhibitors, SGLT2is; DiPeptidyl Peptidase-4 inhibitors, DPP4is) impact body weight, lipid parameters, and blood pressure, as well as endothelial function, inflammatory markers, markers of oxidative stress, and subclinical atherosclerosis. The present review summarizes the results of trials that evaluated the cardiovascular safety of these drugs and found them to be safe from the CV standpoint.

scholarly journals Combination of Linagliptin and Metformin for the Treatment of Patients with Type 2 Diabetes

2015 ◽  
Vol 8 ◽  
pp. CMED.S10360 ◽  
Author(s):  
Thomas Haak
Keyword(s):  
Type 2 Diabetes ◽  
The United States ◽  
Term Treatment ◽  
Dipeptidyl Peptidase 4 ◽  
Treatment Regimens ◽  
Dipeptidyl Peptidase 4 Inhibitor ◽  
Long Term Treatment ◽  
Proven Efficacy ◽  
Single Pill

Type 2 diabetes mellitus (T2DM) is a progressive condition requiring long-term treatment. Most patients with T2DM are unable to maintain normoglycemia using metformin alone; thus, combination therapy is a pivotal part of disease management. Addition of the dipeptidyl peptidase-4 inhibitor linagliptin, with its proven efficacy, low propensity for hypoglycemia, and weight neutrality, has been shown to improve glycemic control for patients who are not well controlled with metformin. As patients often have other comorbidities requiring pharmacotherapy, an increase in pill number, different prescribing frequencies, and timing of medications may adversely impact patients' adherence. Studies have shown that treatment nonadherence contributes to increased morbidity, mortality, and healthcare cost. In the United States, the single-pill combination (SPC) of linagliptin/metformin is available |in three strengths approved for twice-daily administration: 2.5/500 mg, 2.5/850 mg, and 2.5/1000 mg. The SPC has the potential to reduce pill burden and simplify patients' treatment regimens, thereby promoting improved adherence and efficacy.

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