scholarly journals GLP-1a: Going Beyond Traditional Use

2022 ◽  
Vol 23 (2) ◽  
pp. 739
Author(s):  
Lucas Fornari Laurindo ◽  
Sandra Maria Barbalho ◽  
Elen Landgraf Guiguer ◽  
Maricelma da Silva Soares de Souza ◽  
Gabriela Achete de Souza ◽  
...  
Keyword(s):  
Well Being ◽  
Liver Fat ◽  
Traditional Use ◽  
Alcoholic Fatty Liver ◽  
Incretin Hormone ◽  
Glucagon Like Peptide 1 ◽  
Depression Scales ◽  
Diabetes And Obesity

Glucagon-like peptide-1 (GLP-1) is a human incretin hormone derived from the proglucagon molecule. GLP-1 receptor agonists are frequently used to treat type 2 diabetes mellitus and obesity. However, the hormone affects the liver, pancreas, brain, fat cells, heart, and gastrointestinal tract. The objective of this study was to perform a systematic review on the use of GLP-1 other than in treating diabetes. PubMed, Cochrane, and Embase were searched, and the PRISMA guidelines were followed. Nineteen clinical studies were selected. The results showed that GLP-1 agonists can benefit defined off-medication motor scores in Parkinson’s Disease and improve emotional well-being. In Alzheimer’s disease, GLP-1 analogs can improve the brain’s glucose metabolism by improving glucose transport across the blood–brain barrier. In depression, the analogs can improve quality of life and depression scales. GLP-1 analogs can also have a role in treating chemical dependency, inhibiting dopaminergic release in the brain’s reward centers, decreasing withdrawal effects and relapses. These medications can also improve lipotoxicity by reducing visceral adiposity and decreasing liver fat deposition, reducing insulin resistance and the development of non-alcoholic fatty liver diseases. The adverse effects are primarily gastrointestinal. Therefore, GLP-1 analogs can benefit other conditions besides traditional diabetes and obesity uses.

scholarly journals GLP-1 receptor agonists for NAFLD treatment in patients with and without type 2 diabetes: an updated meta-analysis

2020 ◽  
Vol 1 (3) ◽  
pp. 108-123 ◽  
Author(s):  
Alessandro Mantovani ◽  
Giorgia Beatrice ◽  
Graziana Petracca ◽  
Filippo Pampagnin ◽  
Damiano Sandri ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Fat Content ◽  
Liver Fat ◽  
Liver Fat Content ◽  
Alcoholic Fatty Liver ◽  
Receptor Agonists ◽  
Promising Treatment ◽  
Glucagon Like Peptide 1 ◽  
Mean Differences

Aim: Recent randomized controlled trials (RCTs) have tested the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1 RA) to specifically treat non-alcoholic fatty liver disease (NAFLD). We performed a meta-analysis of RCTs to investigate the efficacy of GLP-1 RAs for treatment of NAFLD or non-alcoholic steatohepatitis (NASH). Methods: We systematically searched PubMed and ClinicalTrials.Gov databases utilizing specific terms to identify placebo-controlled or head-to-head RCTs (last research on March 1, 2020) involving NAFLD patients with the aim to evaluate the efficacy of GLP-1 RAs to treat NAFLD/NASH. Primary outcomes were changes in serum liver enzymes, liver fat content, or histologic resolution of NASH. Weighted mean differences (WMD) were used to test the differences between the treatment arms. Results: Overall, we found 7 placebo-controlled or head-to-head RCTs involving 472 middle-aged individuals (66% men; 77% with established diabetes) followed for a median of 16 weeks that have used liraglutide or exenatide to treat NAFLD on imaging (n = 6) or biopsy (n = 1). Compared to placebo or reference therapy, treatment with GLP-1 RAs decreased serum alanine aminotransferase [n = 7 studies; WMD: -8.77 IU/L, 95% confidence intervals (CI) -17.69 to 0.14 IU/L; I2 = 87.3%] and gamma-glutamyltransferase levels (n = 4 studies; WMD: -10.17 IU/L, 95% CI -14.27 IU/L to -6.07 IU/L; I2 = 0%) and imaging-defined liver fat content (n = 4 studies; WMD: -6.23%, 95% CI -8.95% to -3.51%; I2 = 85.9%). In one RCT involving 55 patients with biopsy-proven NASH, a 48-week treatment with liraglutide also led to a greater histological resolution of NASH than placebo. Conclusions: GLP-1 RAs (mostly liraglutide) seem to be a promising treatment option for NAFLD or NASH.

scholarly journals Psychosocial barriers to well‐being and quality of life among type 2 diabetes patients in Ghana

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Margaret Amankwah‐Poku ◽  
Josephine Akpalu ◽  
Araba Sefa‐Dedeh ◽  
Albert G. B. Amoah
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Well Being ◽  
Psychosocial Barriers ◽  
Diabetes Patients

scholarly journals Improving Dietary Recommendations for Patients With Type 2 Diabetes and Obesity in an Endocrinology Clinic

2020 ◽  
Author(s):  
Juan J. Delgado-Hurtado ◽  
Erika L. Kline ◽  
Andrew Crawford ◽  
Auden McClure
Keyword(s):  
Type 2 Diabetes ◽  
Medical Center ◽  
Diabetes Education ◽  
Academic Medical Center ◽  
Dietary Recommendations ◽  
Standard Format ◽  
Diabetes And Obesity ◽  
Endocrinology Clinic

“Quality Improvement Success Stories” are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of <em>Clinical Diabetes</em>. The following article describes a project designed to improve the degree and quality of support for lifestyle change provided to patients with type 2 diabetes and obesity in the outpatient endocrinology clinic of a rural academic medical center.

scholarly journals Glucagon-Like Peptide 1: A Predictor of Type 2 Diabetes?

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
Matthias Ploug Larsen ◽  
Signe Sørensen Torekov
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Acids ◽  
Fasting Glucose ◽  
Incretin Effect ◽  
Nonesterified Fatty Acids ◽  
Incretin Hormone ◽  
Pubmed Database ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Background. The incretin effect is impaired in patients with type 2 diabetes. Aim. To assess the relation between the incretin hormone GLP-1 and the prediabetic subtypes: impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and the combined IFG/IGT to investigate whether a low GLP-1 response may be a predictor of prediabetes in adults. Method. 298 articles were found using a broad search phrase on the PubMed database and after the assessment of titles and abstracts 19 articles were included. Results and Discussion. Studies assessing i-IFG/IFG and i-IGT/IGT found both increased, unaltered, and reduced GLP-1 levels. Studies assessing IFG/IGT found unaltered or reduced GLP-1 levels. When assessing the five studies with the largest sample size, it clearly suggests a decreased GLP-1 response in IFG/IGT subjects. Several other factors (BMI, glucagon, age, and nonesterified fatty acids (NEFA)), including medications (metformin), may also influence the secretion of GLP-1. Conclusion. This review suggests that the GLP-1 response is a variable in prediabetes possibly due to a varying GLP-1-secreting profile during the development and progression of type 2 diabetes or difference in the measurement technique. Longitudinal prospective studies are needed to assess whether a reduced GLP-1 response is a predictor of diabetes.

OXM-104, a potential candidate for the treatment of obesity, NASH and type 2 diabetes

2021 ◽  
Author(s):  
Ashref Kayed ◽  
Simone Melander ◽  
Kim Andreassen ◽  
Morten Karsdal ◽  
Kim Henriksen
Keyword(s):  
Type 2 Diabetes ◽  
Receptor Agonist ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Potential Candidate ◽  
Alcoholic Fatty Liver ◽  
Glucagon Like Peptide 1 ◽  
Treatment Of Obesity ◽  
Long Acting

Abstract Obesity-related metabolic disorders, including non-alcoholic fatty liver disease and its more progressive form non-alcoholic steatohepatitis, are causing an increased health burden, especially due to the lack of approved treatment options. Using preclinical models of NASH, obesity, and type 2 diabetes, we investigated the effects of a long-acting glucagon-like peptide-1(GLP-1) and glucagon (GCG) receptor agonist OXM-104 head to head with once-daily GLP-1/GCG receptor agonist cotadutide and once-weekly GLP-1 receptor agonist semaglutide. OXM-104, cotadutide, and semaglutide elicited marked reductions in body weight and improved glucose control. In contrast, hepatoprotective effects, i.e., reductions in steatosis and fibrosis, as well as liver fibrosis biomarkers, were more prominent with OXM-104 and cotadutide than effects seen with semaglutide. This is demonstrated by improved NAFLD activity score (NAS) by OXM-104 and cotadutide which underlines the importance of the GCG receptor. Thus, these results underline the potential of OXM-104 as a promising therapeutic option for the resolution of NASH, but also as a therapeutic option for type 2 diabetes and obesity.

scholarly journals The effect of type 2 Diabetes Mellitus on health-related quality of life (HRQOL)

Curationis ◽  
2001 ◽  
Vol 24 (1) ◽  
Author(s):  
MS Westaway ◽  
P Rheeder
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
General Health ◽  
Well Being ◽  
Health Related Quality ◽  
Role Functioning ◽  
Related Quality ◽  
Health Related

Improving the quality of life of all South Africans has become a major concern to health care practitioners, organisations and politicians. However, the paucity of local information on health-related quality of life (HRQOL) does not allow us to address this public health challenge. In order to rectify this deficiency and complement international research, we undertook a study with 281 Type 2 Black diabetic patients and 437 controls, with no self-reported chronic conditions, to ascertain HRQOL. We used the SF-20 to measure functioning, general health, wellbeing and bodily pain (HRQOL). It was hypothesised that diabetes mellitus significantly affects functioning, general health and well-being. Multiple analyses of covariance controlled for age, schooling, marital status, employment status and commodity ownership (a socio-economic measure). Patients were significantly more likely to report poorer role functioning, poorer general health and more pain than controls, providing partial support for the hypothesis. Reliability (internal consistency) coefficients on the four multi-item SF-20 sub-scales ranged between 0.79 (well-being), 0.81 (general health), 0.83 (physical functioning) and 0.94 (role functioning) for patients; for controls these coefficients ranged between 0.70 (well-being), 0.78 (general health), 0.80 (physical functioning) and 0.90 (role functioning). Inter-correlations among the sub-scales were significant for patients and controls (p = 0.01). It was concluded that the SF-20 is a reliable instrument for measuring HRQOL in both patient and control samples, and diabetes mellitus has more impact on general health and level of pain than on well-being. Key words: Functioning, general health, well-being, quality of life

scholarly journals Quality of Life and Associated Factors among Primary Care Asian Patients with Type 2 Diabetes Mellitus

2019 ◽  
Vol 16 (19) ◽  
pp. 3561 ◽  
Author(s):  
Hardesh Dhillon ◽  
Rusli Bin Nordin ◽  
Amutha Ramadas
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Well Being ◽  
Care Clinic

Diabetes complications, medication adherence, and psychosocial well-being have been associated with quality of life (QOL) among several Western and Asian populations with diabetes, however, there is little evidence substantiating these relationships among Malaysia’s unique and diverse population. Therefore, a cross-sectional study was conducted in a Malaysian public primary care clinic among 150 patients diagnosed with type 2 diabetes mellitus (T2DM). Structured and validated questionnaires were used to investigate the associations between demographic, clinical, and psychological factors with QOL of the study participants. Approximately three-quarters of patients had a good-excellent QOL. Diabetes-related variables that were significantly associated with poor QOL scores included insulin containing treatment regimens, poor glycemic control, inactive lifestyle, retinopathy, neuropathy, abnormal psychosocial well-being, higher diabetes complication severity, and nonadherence (p < 0.05). The main predictors of a good-excellent QOL were HbA1c ≤ 6.5% (aOR = 20.78, 95% CI = 2.5175.9, p = 0.005), normal anxiety levels (aOR = 5.73, 95% CI = 1.8–18.5, p = 0.004), medication adherence (aOR = 3.35, 95% CI = 1.3–8.7, p = 0.012), and an aDCSI score of one and two as compared to those greater than or equal to four (aOR = 7.78, 95% CI = 1.5–39.2, p = 0.013 and aOR = 8.23, 95% CI = 2.1–32.8, p = 0.003), respectively. Medication adherence has also been found to be an effect modifier of relationships between HbA1c, depression, anxiety, disease severity, and QOL. These predictors of QOL are important factors to consider when managing patients with T2DM.

scholarly journals Effect of Short Term Intensive Lifestyle Intervention on Hepatic Steatosis Indexes in Adults with Obesity and/or Type 2 Diabetes

2019 ◽  
Vol 8 (6) ◽  
pp. 851 ◽  
Author(s):  
Elisa Reginato ◽  
Roberto Pippi ◽  
Cristina Aiello ◽  
Emilia Sbroma Tomaro ◽  
Claudia Ranucci ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Lifestyle Intervention ◽  
Intervention Program ◽  
Liver Fat ◽  
Alcoholic Fatty Liver ◽  
Lifestyle Intervention Program ◽  
Alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) has an estimated prevalence of 20–30% in the general population and even higher in individuals with metabolic risk factors. The aim of this study was to evaluate the effect of a lifestyle intervention program on surrogate markers of hepatic steatosis in obesity and/or type 2 diabetes patients, enrolled in the C.U.R.I.A.Mo. (Centro Universitario di Ricerca Interdipartimentale Attività Motoria) trial. Methods: 102 subjects (56 females and 46 males, aged between 23 and 78) with type 2 diabetes, obesity or a BMI of at least 25 kg/m2 with comorbidities, participated in the intensive phase of a multidisciplinary lifestyle intervention program at the Healthy Lifestyle Institute of the University of Perugia (C.U.R.I.A.Mo.). Six indices related to NAFLD (Visceral Adiposity Index, Fatty Liver index, Non-Alcoholic Fatty Liver Disease liver fat score and liver fat equation, hepatic steatosis index and TyG index) were calculated before and after a three-month multidisciplinary lifestyle intervention. Results: The intervention improved the anthropometric and clinical parameters in the total population, the obese and/or diabetics. Data showed a significant weight loss, a reduced waist circumference, triglycerides, and an improvement in Mediterranean diet adherence. Hepatic steatosis indices were significantly reduced in the total population and in different subgroups (males, females, obesity and diabetes).

scholarly journals Effects of GLP-1 and Incretin-Based Therapies on Gastrointestinal Motor Function

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Chinmay S. Marathe ◽  
Christopher K. Rayner ◽  
Karen L. Jones ◽  
Michael Horowitz
Keyword(s):  
Inhibitory Action ◽  
Current Knowledge ◽  
Incretin Hormone ◽  
Distal Small Intestine ◽  
Gastrointestinal Motor ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Antiobesity Agents ◽  
Motor Actions

Glucagon-like peptide 1 (GLP-1) is a hormone secreted predominantly by the distal small intestine and colon and released in response to enteral nutrient exposure. GLP-1-based therapies are now used widely in the management of type 2 diabetes and have the potential to be effective antiobesity agents. Although widely known as an incretin hormone, there is a growing body of evidence that GLP-1 also acts as an enterogastrone, with profound effects on the gastrointestinal motor system. Moreover, the effects of GLP-1 on gastrointestinal motility appear to be pivotal to its effect of reducing postprandial glycaemic excursions and may, potentially, represent the dominant mechanism. This review summarizes current knowledge of the enterogastrone properties of GLP-1, focusing on its effects on gut motility at physiological and pharmacological concentrations, and the motor actions of incretin-based therapies. While of potential importance, the inhibitory action of GLP-1 on gastric acid secretion is beyond the scope of this paper.

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