scholarly journals Incretin-Based Antidiabetic Agents: A New Option for Type-2 Diabetes Mellitus

1970 ◽  
Vol 6 (1) ◽  
pp. 51-54
Author(s):  
F Ahammad ◽  
MAR Howlader ◽  
RC Barnab ◽  
MY Ali ◽  
S Naher ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Complex Disease ◽  
Vascular Dysfunction ◽  
Glucagon Secretion ◽  
Dipeptidyl Peptidase 4 ◽  
Glucagon Like Peptide 1 ◽  
Microvascular And Macrovascular Complications

Type 2 Diabetes Mellitus (T2DM) is a complex disease with the co-existence of several pathophysiological abnormalities. Both microvascular and macrovascular complications are the main causes of morbidity and mortality, which develops due to endothelial dysfunction. Upregulation of reactive oxygen species, chronic inflammatory and hypercoagulable states are the pathologic basis of vascular dysfunctions in T2DM. To overcome all these abnormalities, different classes of antihyperglycaemic agents have developed. Unfortunately none is able to show satisfactory glycaemic control and to modulate vascular dysfunction. Incretin hormones are secreted from intestine during meal, which enhance insulin secretion and inhibit glucagon secretion from the pancreas. The incretin effect is severely reduced or absent in T2DM. Incretin-based new antidiabetics, both Dipeptidyl Peptidase-4 (DPP-4) inhibitors (Saxagliptin, Sitagliptin, Vildagliptin) and Glucagon Like Peptide-1 (GLP-1) analogs (Exenatide) are now being used globally. They are almost equally effective as conventional antidiabetics like Sulphonylureas (SU), Metformin (MET), Thiazolidinediones (TZD) and insulin when given as monotherapy or combined with SU, MET or TZD as second line agent. Incretin-based agents do not cause hypoglycaemia, produce weight loss in spite of weight gain and do not retain salt or water and almost no gastrointestinal (GIT) symptoms. The agents correct vascular dysfunctions and dyslipidaemia and can be given in elderly and renal impaired patients. DOI: 10.3329/fmcj.v6i1.7412 Faridpur Med. Coll. J. 2011;6(1): 51-54

Pharmacotherapy for Type 2 Diabetes Mellitus: What’s Up and Coming in the Glucagon-Like Peptide-1 (GLP-1) Pipeline?

2021 ◽  
pp. 089719002110490
Author(s):  
Mary J. Elder ◽  
Emily J. Ashjian
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glucagon Secretion ◽  
New Drugs ◽  
Beneficial Effects ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Glucagon-like peptide-1 (GLP-1), an incretin hormone, is known to lower glucose levels, suppress glucagon secretion, and slow gastric emptying. These properties make GLP-1 an ideal target in treating type 2 diabetes mellitus (T2DM). There are many FDA-approved GLP-1 agonists on the market today, several of which have demonstrated benefit beyond improving glycemic control. Given the beneficial effects of GLP-1 agonists in patients with T2DM, new drugs are in development that combine the mechanism of action of GLP-1 receptor agonism with novel mechanisms and with drugs that promote GLP-1 secretion. These agents are designed to improve glycemic control and target greater body weight reduction. This article discusses new GLP-1 drugs in the pipeline for the treatment of T2DM.

scholarly journals Possible applications of gliptins (dipeptidyl peptidase-4 inhibitors) in patients with type 2 diabetes mellitus on the various modes of insulin therapy

2015 ◽  
Vol 18 (4) ◽  
pp. 87-91 ◽  
Author(s):  
Gagik Radikovich Galstyan ◽  
Svetlana Viktorovna Sergeeva
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Glucagon Secretion ◽  
Insulin Requirement ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors

The evidence for DPP-4 inhibitors effectiveness at the late stages of type 2 diabetes mellitus (T2DM) are still growing. This is particularly important for those patients who receive insulin without adequately glycemic control. This publication provides the overview of studies which demonstrate high efficacy of Vildagliptin in reducing the blood glucose level in patients with hight duration of T2DM and insulin therapy. DPP-4 inhibitors normalize basal and postprandial glucagon secretion with pancreas α-cells that helps to provide better glycemic control and to reduce a risk of hypoglycemia. Besides, there are very interesting data for Vildagliptin to reduce insulin requirement in T2DM patients in addition to HbA1clevel decrease.

scholarly journals Add-on saxagliptin improves glycemic status among uncontrolled type 2 diabetes mellitus

2018 ◽  
Vol 6 (5) ◽  
pp. 1682
Author(s):  
Butungeshwar Pradhan ◽  
Chakradhar Majhi ◽  
Madhusmita Sahu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Postprandial Glucose ◽  
Glycemic Status ◽  
Dipeptidyl Peptidase 4 ◽  
Spss Software ◽  
Glucagon Like Peptide 1 ◽  
Insulinotropic Peptide

Background: Type 2 diabetes mellitus (T2DM) have multiple pathophysiologic defects contributing to hyperglycemia. T2DM patients have insulin resistance with progressive β-cell failure and progressive insulin secretion defect. Dipeptidyl peptidase-4 (DPP-4) inhibitors target the incretin system. saxagliptin is a DPP-4 inhibitor slowing the degradation of Glucagon-like peptide-1 (GLP-1) and Glucose-dependent insulinotropic peptide (GIP) sustain the incretin effects. Aim was to know the add-on effects of saxagliptin among uncontrolled T2DM.Methods: A total of 71 uncontrolled T2DM patients on various antidiabetic therapies except incretin mimetic were consecutively selected for the study. Baseline fasting plasma glucose (FPG), 2hour postprandial glucose (PPG) and glycated hemoglobin (HbA1c) was measured. Saxagliptin orally 5mg/day was given after approval of ethical committee and FPG, 2hour PPG and HbA1c was measured at 12 weeks and 24 weeks. Data were collected and analyzed by ‘t’ test using SPSS software version 25.Results: Baseline FPG, 2hour PPG and HbA1c was 158.4±13.9mg%, 252.6±24.4mg% and 8.6±1.3% respectively. Percentage of patients achieved HbA1c of <7% at 12 weeks was 16.9% and 43.6% at 24 weeks (P <0.05). Adjusted mean difference in HbA1c was 0.73% at 12 weeks and 1.2 % at 24 weeks (P <0.05). Reduction of mean FPG, 2hour PPG and HbA1c was 154.48±13.8mg%, 240.31±26.8mg% and 7.93±1.1% at 12 weeks and 151.15±13.7mg%, 231.7±27mg% and 7.38±1% at 24 weeks respectively (P <0.05). Patients on insulin were better responded.Conclusions: Add-on saxagliptin improves all parameter of glycemic status in uncontrolled type 2 DM patients.

scholarly journals Study the effect of Dipeptidyl Peptidase 4 Inhibitors as an Antidiabetic in Type 2 Diabetes Mellitus (T2DM)

2021 ◽  
Vol 11 (5) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Dipeptidyl Peptidase ◽  
Dipeptidyl Peptidase 4 ◽  
Dpp Iv ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

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

scholarly journals The association of amputations and peripheral artery disease in patients with type 2 diabetes mellitus receiving sodium-glucose cotransporter type-2 inhibitors: real-world study

2020 ◽  
Author(s):  
Sanjoy K Paul ◽  
Deepak L Bhatt ◽  
Olga Montvida
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Dipeptidyl Peptidase 4 ◽  
Sodium Glucose Cotransporter ◽  
Glucagon Like Peptide 1 ◽  
Artery Disease

Abstract Aims  The aim of this study was to evaluate the temporal pattern of amputations in patients with type 2 diabetes mellitus (T2DM), the risk of amputations by new and older anti-diabetic drugs (ADDs), and the interplay of peripheral artery disease (PAD) with therapy and amputation risk. Methods and results  Using Centricity Electronic Medical Records from USA, 3 293 983 patients with T2DM were identified: 169 739 received sodium-glucose cotransporter type-2 inhibitors (SGLT-2i; no exposure to incretins); 149 826 received glucagon-like peptide 1 receptor agonists [GLP-1RA, no SGLT-2i or dipeptidyl peptidase-4 inhibitor (DPP-4i) exposure]; 448 225 received DPP-4i (no exposure to GLP-1RA or SGLT-2i); and 1 954 353 received other ADDs. The proportion of incident amputations per 10 000 adults ranged between 4.7 and 6.8 during 2000–08 and significantly increased to 12.3 in 2017. Over 17 211 719 person-years follow-up post T2DM diagnosis, the rates per 1000 person-years of any and lower limb amputations (LLAs) were similar between SGLT-2i and incretins [95% confidence interval (CI) range: 1.06–1.67], and significantly higher in other groups (95% CI range: 1.96–2.29). In propensity score-adjusted pairwise analyses, the risk of LLA was not higher in SGLT-2i vs. GLP1-RA [hazard ratio (HR) (95% CI): 0.88 (0.73, 1.05)], and lower in SGLT-2i vs. DPP-4i/other ADD [HR (95% CI): 0.65 (0.56, 0.75)/0.43 (0.37, 0.49)]. The rate of LLA was similar in patients treated with canagliflozin, empagliflozin, or dapagliflozin. Patients with PAD had more than four-fold higher LLA risk (range of 95% CI of HR: 3.6–6.0). Conclusion  The risk of amputation in patients treated with SGLT-2i and incretins was not higher compared with other ADDs. Pre-existing PAD was the greatest driver of amputation risk.

scholarly journals Modern antihyperglycemic agents prescribed in Russia for type 2 diabetes mellitus

2012 ◽  
Vol 15 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Yury Ivanovich Suntsov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Analogues ◽  
Treatment Patterns ◽  
Prescription Patterns ◽  
Dipeptidyl Peptidase 4 ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

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.

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