PMID: 20631270Jul 16, 2010Paper

Incretin agents in type 2 diabetes.

Canadian Family Physician Médecin De Famille Canadien
Stuart A Ross, Jean-Marie Ekoé

Abstract

To evaluate the emerging classes of antihyperglycemic agents that target the incretin pathway, including their therapeutic efficacy and side effect profiles, in order to help identify their place among the treatment options for patients with type 2 diabetes. MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched. Most evidence is level I and II. Two classes of incretin agents are currently available: glucagonlike peptide 1 (GLP1) receptor agonists and dipeptidyl peptidase 4 (DPP4) inhibitors, both of which lower hyperglycemia considerably without increasing the risk of hypoglycemia. The GLP1 receptor agonists have a greater effect on patients' glycated hemoglobin A(1c) levels and cause sustained weight loss, whereas the DPP4 inhibitors are weight-neutral. The GLP1 and DPP4 incretin agents, promising and versatile antihyperglycemic agents, are finding their way into the therapeutic algorithm for treating type 2 diabetes. They can be used in patients not adequately controlled by metformin monotherapy or as initial therapy in those for whom metformin is contraindicated.

References

Jun 2, 2009·The American Journal of Medicine·Matthew P Gilbert, Richard E Pratley
Jul 17, 2009·European Journal of Internal Medicine·David M KendallRichard M Bergenstal

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