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Multifactorial intervention in type 2 diabetes: the promise of incretin-based therapies.
MedLine Citation:
PMID:  21233599     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Type 2 diabetes mellitus (T2DM) is increasing in prevalence at alarming rates. Concurrent with the its expanding prevalence, is the increase in the related risk of morbidity and mortality. Because diabetic patients are prone to cardiovascular disease, treatment strategies should address the cardiovascular risk factors, including blood pressure, lipids, and body weight, in addition to the glycemic aspects of the disease. Newer agents, such as glucagon-like peptide-1 (GLP-1) analogs and dipeptidyl peptidase-4 (DPP-4) inhibitors, have varying degrees of evidence to support their effects on body weight, blood pressure, and lipid levels, beyond glycated hemoglobin (HbA1c) reduction. While GLP-1 agonists produce a weight loss, the DPP-4 inhibitors, conversely, appear to have a weight-neutral effect. Substantial evidence demonstrates that both medications produce modest reductions in systolic blood pressure and, in some cases, diastolic blood pressure, and reduce several markers of cardiovascular risk, including C-reactive protein. Moreover, GLP-1 influences endothelial function. The effect of the incretin hormones on serum lipids are either neutral or beneficial, with small, non-significant decreases in low-density lipoprotein cholesterol, increases in high-density lipoprotein cholesterol, and occasionally significant decreases in fasting triglyceride levels. Also, they have positive effects on hepatic steatosis. Although GLP-1 agonists and DPP-4 inhibitors are at present not appropriate for primary treatment of cardiovascular risks factors, the reduction of these parameters is evidently beneficial.
Authors:
Francesco Giorgino; Anna Leonardini; Annalisa Natalicchio; Luigi Laviola
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-13
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  -     ISSN:  1720-8386     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Emergency and Organ Transplantation - Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Università degli Studi di Bari "Aldo Moro", Bari, Italy. f.giorgino@endo.uniba.it.
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