The role of incretin on diabetes mellitus

Beta cell dysfunction in type-2 diabetes mellitus holds an important role not just on its pathogenesis, but also on the progression of the disease. Until now, diabetes treatment cannot restore the reduced function of pancreatic beta cell. McIntyre et al stated that there is a factor from the intestine which stimulates insulin secretion as a response on glucose.This factor is known as incretin. It is a hormone which is released by the intestine due to ingested food especially those which contain carbohydrate and fat. Currently, there are 2 types of incretin hormones which have been identified, i.e.Glucose dependent insulinotropic polypeptide (GIP) and Glucagon like peptide-1 (GLP-1). These two hormones act by triggering insulin release immediately after food ingestion, inhibiting glucagon secretion, delaying stomach emptying, and suppressing hunger sensation. Several in vitro studies have demonstrated that these two incretin hormones may increase the proliferation of pancreatic beta cell.There is a decrease of GIP function and GLP-1 amount in type-2 diabetes mellitus; thus the attempt to increase both incretin hormones - in this case by using GLP-1 agonist and DPP-IV inhibitor - is one of treatment modalities to control the glucose blood level, either as a monotherapy or a combination therapy. Currently, there are two approaches of incretin utilization as one of type-2 diabetes mellitus treatment, which is the utilization of incretin mimetic/agonist and DPP-IV inhibitor.