Incretin-based therapies: focus on effects beyond glycemic control alone.
Incretin-based therapies: focus on effects beyond glycemic control alone.
复制标题
DOI：
10.1007/s13300-013-0040-0
复制
发表时间：
2013-12
期刊：
影响因子：
--
通讯作者：
Davidson JA
中科院分区：
文献类型：
--
作者：
Davidson JA
2型糖尿病与高血压、血脂异常和高血糖引起的合并症的高患病率有关。对这些风险因素管理不当，最终将导致有害的健康后果。因此，药物对体重、心血管(CV)危险因素和依从性等因素的影响是值得考虑的。本文综述了两类以胰岛素为基础的治疗药物--胰升糖素样肽-1受体激动剂(GLP-1RA)和二肽基肽酶-4(DPP-4)抑制剂的血糖外特性。执行PubMed搜索以确定已发表的关于胰岛素疗法的数据，这些数据描述了它们对心血管风险因素、心血管事件和与服药依从性相关的因素的影响。与使用GLP-1RAs和DPP-4抑制剂相关的体重维持或减轻在医学文献中有很好的描述。这些药物似乎也与血压的适度下降和心血管事件风险的降低有关。此外，胰岛素疗法的几个特点可能会提高用药依从率，例如普遍良好的耐受性(特别是使用DPP-4抑制剂)、可获得简化治疗方案的配方以及低血糖风险。有关胰岛素治疗的文献描述了一些与血糖外危险因素管理相关的临床特征。作为整体治疗策略的一部分，这些特性构成了为2型糖尿病个体患者量身定做治疗的重要考虑因素。
Type 2 diabetes is associated with a high prevalence of comorbidities resulting from hypertension, dyslipidemia, and hyperglycemia. Inadequate management of these risk factors will eventually result in detrimental health consequences. Thus, the effect of a drug on factors such as weight, cardiovascular (CV) risk factors, and adherence is important to consider. A review was undertaken of the recent medical literature describing the extraglycemic characteristics of the two classes of incretin-based therapies—glucagon-like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-4 (DPP-4) inhibitors. PubMed searches were performed to identify published data on incretin therapies that describe their effects on CV risk factors, CV events, and factors related to medication adherence. The maintenance or loss of weight associated with the use of GLP-1RAs and DPP-4 inhibitors is well described in the medical literature. These agents also appear to be associated with a modest decrease in blood pressure and a reduced risk of CV events. In addition, several characteristics of incretin therapies may improve rates of medication adherence, such as generally favorable tolerability profiles (particularly with DPP-4 inhibitors), the availability of formulations that simplify treatment regimens, and a low risk for hypoglycemia. The literature on incretin therapies describes a number of clinical characteristics that are relevant to the management of extraglycemic risk factors. As part of a holistic treatment strategy, these properties constitute important considerations for tailoring therapy to individual patients with type 2 diabetes.
登录
查看更多内容
影响因子：
16.2
作者：
Buse JB;Drucker DJ;Taylor KL;Kim T;Walsh B;Hu H;Wilhelm K;Trautmann M;Shen LZ;Porter LE;DURATION-1 Study Group
通讯作者：
DURATION-1 Study Group
影响因子：
2.3
作者：
Fabunmi, Rosalind;Nielsen, Loretta L.;Wade, Ron
通讯作者：
Wade, Ron
影响因子：
5.8
作者：
Del Prato, S.;Barnett, A. H.;Dugi, K. A.
通讯作者：
Dugi, K. A.
影响因子：
16.2
作者：
Aschner, Pablo;Kipnes, Mark S.;Williams-Herman, Debora E.
通讯作者：
Williams-Herman, Debora E.
影响因子：
105.7
作者：
Adler, AI;Stratton, IM;Holman, RR
通讯作者：
Holman, RR