Related Experiment Video
Updated: Dec 17, 2025
06:09
An In Ovo Model for Testing Insulin-mimetic Compounds
Published on: April 23, 2018
11.0K
[New oral antidiabetic drugs]
Dirk Müller-Wieland1, Katharina Schütt2, Julia Brandts2
1Medizinische Klinik I, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland. dirmueller@ukaachen.de.
Herz
|July 1, 2020
Summary
New oral antidiabetic agents represent a paradigm shift in type 2 diabetes management. Cardiovascular and renoprotective benefits now guide treatment choices over HbA1c alone, especially for high-risk patients.
Area of Science:
- Endocrinology and Metabolism
- Cardiovascular Medicine
- Nephrology
Background:
- The treatment landscape for type 2 diabetes (T2D) is evolving with novel oral antidiabetic agents.
- Cardiovascular (CV) outcome studies have established safety profiles and efficacy beyond glycemic control.
Purpose of the Study:
- To review the impact of new oral antidiabetic agents on clinical guidelines for T2D management.
- To highlight the importance of cardiorenal risk assessment in selecting antidiabetic therapies.
Main Methods:
- Analysis of cardiovascular endpoint studies for dipeptidyl peptidase 4 (DPP-4) inhibitors.
- Evaluation of cardiovascular, heart failure, and renoprotective effects of glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose linked transporter 2 (SGLT-2) inhibitors.
Main Results:
- DPP-4 inhibitors demonstrate CV safety.
- GLP-1 receptor agonists and SGLT-2 inhibitors show CV protective effects.
- SGLT-2 inhibitors uniquely reduce heart failure risk and offer renoprotection.
Conclusions:
- Clinical guidelines now recommend SGLT-2 inhibitors or GLP-1 receptor agonists for cardiorenal risk reduction in T2D, irrespective of HbA1c levels.
- SGLT-2 inhibitors are the preferred choice for patients with existing or high risk of chronic heart failure.
- Antidiabetic treatment selection is increasingly driven by individual patient cardiorenal risk rather than solely by HbA1c.
Keywords:
DPP‑4 inhibitorsDiabetes mellitus type 2GLP‑1 receptor agonistsHeart failureSodium-glucose transporter 2 inhibitorsMore Related Videos
07:30Homogeneous Time-resolved Förster Resonance Energy Transfer-based Assay for Detection of Insulin Secretion
Published on: May 10, 2018
9.6K
09:31Sustained Administration of β-cell Mitogens to Intact Mouse Islets Ex Vivo Using Biodegradable Poly(lactic-co-glycolic acid) Microspheres
Published on: November 5, 2016
7.6K
Related Concept Videos
01:06Oral Hypoglycemic Agents: Glinides
485
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...
485
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
514
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...
514
01:19Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
443
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...
Acarbose and miglitol are...
443
01:17Oral Hypoglycemic Agents: Sulfonylureas
627
Sulfonylureas are oral hypoglycemic agents utilized in treating type 2 diabetes. They are characterized by their unique sulfonylurea chemical structure. The family of sulfonylureas is divided into generations. First-generation sulfonylureas, including tolbutamide (Orinase), chlorpropamide (Diabinese), and tolazamide (Tolinase), trigger insulin release from pancreatic β cells and enhance peripheral tissues' insulin sensitivity. The second-generation members, such as glipizide...
627
01:24Glucagon-like Receptor Agonists
720
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...
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...
720
01:23Dipeptidyl Peptidase 4 Inhibitors
460
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...
460