TY - JOUR

T1 - Glucagon-like peptide receptor agonists and dipeptidyl peptidase-4 inhibitors in the treatment of diabetes

T2 - a review of clinical trials

AU - Madsbad, Sten

AU - Krarup, Thure

AU - Deacon, Carolyn F

AU - Holst, Jens Juul

PY - 2008/7

Y1 - 2008/7

N2 - PURPOSE OF REVIEW: To discuss 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 FINDINGS: The 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.SUMMARY: The 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.

AB - PURPOSE OF REVIEW: To discuss 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 FINDINGS: The 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.SUMMARY: The 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.

KW - Adamantane

KW - Clinical Trials as Topic

KW - Diabetes Mellitus, Type 2

KW - Dipeptidyl Peptidase 4

KW - Dipeptidyl-Peptidase IV Inhibitors

KW - Glucagon-Like Peptide 1

KW - Glucagon-Like Peptides

KW - Humans

KW - Hypoglycemic Agents

KW - Nitriles

KW - Peptides

KW - Pyrazines

KW - Pyrrolidines

KW - Receptors, Glucagon

KW - Triazoles

KW - Venoms

U2 - 10.1097/MCO.0b013e328302f414

DO - 10.1097/MCO.0b013e328302f414

M3 - Journal article

C2 - 18542012

VL - 11

SP - 491

EP - 499

JO - Current Opinion in Clinical Nutrition and Metabolic Care

JF - Current Opinion in Clinical Nutrition and Metabolic Care

SN - 1363-1950

IS - 4

ER -