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Incretin-Based Therapies for Diabetic Complications: Basic Mechanisms and Clinical Evidence

Daiji Kawanami1, Keiichiro Matoba2, Kazunori Sango3

  • 1Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. daijika@jikei.ac.jp.

International Journal of Molecular Sciences
|August 3, 2016
PubMed

Insights

Incretin-based therapies, including DPP-4 inhibitors and GLP-1 receptor agonists, show promise in managing diabetic complications. These treatments offer benefits beyond glucose control, potentially reducing inflammation and oxidative stress.

Area of Science:

  • Endocrinology and Metabolism
  • Pharmacology
  • Diabetology

Background:

  • Diabetic complications significantly increase morbidity and mortality worldwide.
  • Effective glycemic control is crucial for preventing and managing these complications.
  • Various antidiabetic agents are available, with ongoing research into their pleiotropic effects.

Purpose of the Study:

  • To review experimental and clinical evidence on incretin-based therapies for diabetic complications.
  • To evaluate the glucose-lowering and independent effects of DPP-4 inhibitors and GLP-1 RAs.
  • To assess the impact of these therapies on microvascular and macrovascular complications in type 2 diabetes.

Main Methods:

  • Review of experimental studies investigating the mechanisms of incretin-based therapies.
  • Analysis of clinical trial data assessing the efficacy of DPP-4 inhibitors and GLP-1 RAs.
  • Evaluation of evidence regarding anti-inflammatory and anti-oxidative stress properties.

Main Results:

  • Experimental studies suggest incretin-based therapies possess beneficial effects on diabetic complications independent of glucose lowering.
  • These effects are attributed to anti-inflammatory and anti-oxidative stress properties.
  • Clinical studies provide mixed evidence, with several supporting but not all confirming benefits on micro- and macrovascular complications.

Conclusions:

  • Incretin-based therapies, including DPP-4 inhibitors and GLP-1 RAs, are widely used for type 2 diabetes.
  • Evidence supports their potential to mitigate diabetic complications through mechanisms beyond glycemic control.
  • Further research and comprehensive clinical data are needed to fully elucidate their role in managing diabetic complications.
Keywords:
DPP-4GLP-1cardiovascular diseasediabetesdiabetic complicationsglucose-dependent insulinotropic polypeptide (GIP)incretin

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