Glucagon-like peptide receptor agonists and dipeptidyl peptidase-4 inhibitors in the treatment of diabetes: a review of clinical trials
Glucagon-like peptide receptor agonists and dipeptidyl peptidase-4 inhibitors in the treatment of diabetes: a review of clinical trials
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DOI：
10.1097/mco.0b013e328302f414
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发表时间：
2008-07-01
影响因子：
3.1
通讯作者：
Holst, Jens J.
中科院分区：
文献类型：
--
作者：
Madsbad, Sten;Krarup, Thure;Holst, Jens J.
综述目的探讨胰高血糖素样肽-1受体激动剂和二肽基肽酶-4抑制剂在2型糖尿病治疗中的优点和缺点。最近的发现可注射的胰高血糖素样肽-1受体激动剂艾塞那肽显著改善了血糖控制，平均降低血红蛋白A1 c约1.0%，空腹血糖约1.4 mmol/l，并在2型糖尿病患者中治疗30周后导致体重减轻约2-3 kg。副作用是短暂的恶心和呕吐。长效胰高血糖素样肽-1受体激动剂利拉鲁肽和艾塞那肽长效释放可使血红蛋白A1 c降低约1.0 - 2.0%，胃肠道副作用较少。口服可利用的二肽基肽酶-4抑制剂，即西他列汀和维格列汀使血红蛋白A1 c降低0.5- 1.0%，血糖素样肽-1类似物和二肽基肽酶-4抑制剂在糖尿病治疗方案中的益处和地位将在我们进行长期研究时阐明。具有硬心血管终点的长期试验和说明对2型糖尿病进展影响的数据。
Purpose of reviewTo discus the virtues and shortcomings of the glucagon-like peptide-1 receptor agonists and the dipeptidyl peptidase-4 inhibitors in the treatment of type 2 diabetes.Recent findingsThe injectable glucagon-like peptide-1 receptor agonists exenatide significantly improves glycaemic control, with average reductions in haemoglobin A1c of about 1.0%, fasting plasma glucose of about 1.4 mmol/l, and causes a weight loss of approximately 2-3 kg after 30 weeks of treatment in patients with type 2 diabetes. The adverse effects are transient nausea and vomiting. The long-acting glucagon-like peptide-1 receptor agonists liraglutide and exenatide long-acting release reduce haemoglobin A1c by about 1.0 - 2.0% and have fewer gastrointestinal side-effects. The orally available dipeptidyl peptidase-4 inhibitors, that is sitagliptin and vildagliptin reduce haemoglobin A1c by 0.5- 1.0%, are weight neutral and without gastrointestinal side-effects.SummaryThe benefits and position of the glucagon-like peptide-1 analogues and the dipeptidyl peptidase-4 inhibitors in the diabetes treatment algorithm will be clarified when we have long-term trials with hard cardiovascular endpoints and data illustrating the effects on the progression of type 2 diabetes.