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Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

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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...
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Insulin: Dosing Regimen and Adverse Effects01:16

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
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Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

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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...
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Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

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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...
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Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

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Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
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Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

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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...
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GLP-1 Injectable Use Among Adults With Diagnosed Diabetes: United States, 2024.

Anjel Vahratian, Antonia Warren

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    Summary

    In 2024, 26.5% of adults with diagnosed diabetes used injectable glucagon-like peptide-1 (GLP-1) receptor agonists. Use varied by age, race, and BMI, with higher prevalence in younger adults and certain racial groups.

    Keywords:
    National Health Interview Survey (NHIS)dulaglutideglycemic controlincretin mimeticssemaglutide

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    Area of Science:

    • Endocrinology and Metabolism
    • Public Health Surveillance
    • Diabetes Management

    Background:

    • Injectable glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly utilized for type 2 diabetes management.
    • Understanding the current uptake and demographic patterns of GLP-1 injectable use is crucial for public health initiatives.
    • The 2024 National Health Interview Survey (NHIS) provides a valuable dataset for assessing these trends.

    Purpose of the Study:

    • To determine the percentage of U.S. adults with diagnosed diabetes using injectable GLP-1 receptor agonists in 2024.
    • To examine the association between GLP-1 injectable use and selected demographic and clinical characteristics.
    • To identify trends in GLP-1 injectable utilization across different age groups, racial/ethnic backgrounds, and medication regimens.

    Main Methods:

    • Analysis of data from the 2024 National Health Interview Survey (NHIS).
    • Identification of GLP-1 injectable users based on self-reported use of non-insulin injectable medications for blood sugar control or weight loss.
    • Statistical analysis using SAS-callable SUDAAN software to account for the complex survey design, with significance testing at the 0.05 level.

    Main Results:

    • In 2024, 26.5% of adults with diagnosed diabetes reported using injectable GLP-1 receptor agonists.
    • GLP-1 injectable use showed an inverted U-shaped trend with age, peaking in the 50-64 age group (33.3%) and lower in younger (18-34: 25.3%) and older (≥65: 20.8%) adults.
    • Higher prevalence of use was observed among Hispanic (31.3%), Black non-Hispanic (26.5%), and White non-Hispanic (26.2%) adults compared to Asian non-Hispanic adults (12.1%).
    • Use was positively associated with higher body mass index and concurrent use of insulin or oral glucose-lowering medications.

    Conclusions:

    • Injectable GLP-1 receptor agonist use is substantial among U.S. adults with diagnosed diabetes in 2024.
    • Significant variations in uptake exist across demographic groups, highlighting potential disparities or targeted prescribing patterns.
    • Further research should explore the factors driving these utilization patterns and their impact on diabetes outcomes.