Treatment of Type 1 Diabetic Patients with Glucagon-Like Peptide-1 (GLP-1) and GLP-1R Agonists
Treatment of Type 1 Diabetic Patients with Glucagon-Like Peptide-1 (GLP-1) and GLP-1R Agonists
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DOI：
10.2174/157339909789804413
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发表时间：
2009-01-01
影响因子：
3.3
通讯作者：
Madsbad, Sten
中科院分区：
文献类型：
--
作者：
Kielgast, Urd;Holst, Jens J.;Madsbad, Sten
GLP-1（胰高血糖素样肽-1）是一种肽类激素，由肠粘膜内分泌细胞对进食作出反应而分泌。GLP-1的主要作用是增加葡萄糖诱导的胰岛素分泌和减少胰高血糖素释放，但GLP-1还抑制肥胖受试者的胃排空率并降低食欲和体重。使用2型糖尿病动物模型的体内研究和使用人胰岛细胞的体外研究表明，GLP-1或GLP-1类似物也能够增加β细胞质量，但在1型糖尿病动物模型中，β细胞保留作用的证据要少得多。本文综述了GLP-1及其类似物在1型糖尿病患者治疗中的作用。将对GLP-1和GLP-1类似物对2型和1型糖尿病β细胞质量的影响以及GLP-1作为胰岛细胞移植辅助治疗的潜力进行综述。对GLP-1治疗1型糖尿病的未来研究的建议可能包括早期治疗，以保护β细胞群并延长缓解期，但也应考虑潜在的胰岛素节省效应和低血糖风险的变化。
GLP-1 (glucagon-like peptide-1) is a peptide hormone secreted from endocrine cells in the intestinal mucosa in response to meals. The major effects of GLP-1 are to increase glucose-induced insulin secretion and reduce glucagon release, but GLP-1 also inhibits gastric emptying rate and reduces appetite and bodyweight in obese subjects. In vivo studies using animal models of type 2 diabetes and in vitro studies using human islet cells have suggested that GLP-1 or GLP-1 analogues are also able to increase beta-cell mass, but in animal models of type 1 diabetes, there is much less evidence for a beta-cell preserving effect. This review summarizes the present knowledge of GLP-1 and its analogues regarding its role as a possible treatment in patients with type 1 diabetes. The studies that address the effect of GLP-1 and GLP-1 analogues on beta-cell mass in both type 2 and type 1 diabetes, as well as the potential of GLP-1 as an adjuvant therapy in islet cell transplantation, will be reviewed. Suggestions for future studies of GLP-1 treatment in type 1 diabetes may include early treatment in order to preserve beta-cell mass and prolong the remission period, but should also take a potential insulin sparing effect and changes in the risk of hypoglycemia into account.