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Related Concept Videos

Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by the...
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a significant...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

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Mechanisms Underlying Gut Hormone Secretion Using the Isolated Perfused Rat Small Intestine
07:00

Mechanisms Underlying Gut Hormone Secretion Using the Isolated Perfused Rat Small Intestine

Published on: February 26, 2019

Recent advances in incretin-based therapies.

David Russell-Jones1, Stephen Gough

  • 1Diabetes and Endocrinology, The Royal Surrey County Hospital & University of Surrey, Guildford, UK. davidrussell-jones@nhs.net

Clinical Endocrinology
|July 19, 2012
PubMed
Summary

New incretin-based therapies offer improved glucose control for type 2 diabetes, addressing obesity and cardiovascular risks without hypoglycemia. This review details their development and clinical profiles.

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Type 2 diabetes (T2D) presents a growing global health challenge.
  • Existing T2D treatments are often suboptimal, failing to adequately manage hyperglycemia, obesity, and cardiovascular risks.
  • There is a significant unmet need for therapies that provide effective glucose lowering without inducing hypoglycemia.

Purpose of the Study:

  • To review the development and mechanisms of incretin-based therapies for T2D.
  • To compare the clinical profiles of current glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4i).
  • To discuss the role of incretin-based therapies in current treatment guidelines and explore future developments.

Main Methods:

  • Literature review of incretin-based therapies.
  • Comparative analysis of GLP-1 RAs (liraglutide, exenatide) and DPP-4 inhibitors (sitagliptin, saxagliptin, vildagliptin, linagliptin).
  • Examination of treatment guidelines and emerging therapies.

Main Results:

  • Incretin-based therapies, including GLP-1 RAs and DPP-4 inhibitors, offer novel approaches to hyperglycemia management.
  • These agents target the incretin system, providing distinct mechanisms of action compared to traditional diabetes interventions.
  • Clinical profiles vary among different GLP-1 RAs and DPP-4 inhibitors, influencing their place in therapy.

Conclusions:

  • Incretin-based therapies represent a significant advancement in T2D management, offering effective glucose control and addressing comorbidities.
  • Ongoing research and development promise further improvements in this therapeutic class.
  • These agents are increasingly recognized and integrated into T2D treatment guidelines.