Newer therapeutic options for children with diabetes mellitus: theoretical and practical considerations.

Pediatric Diabetes
George S Jeha, Rubina A Heptulla

Abstract

Recent studies in adult patients with type 1 diabetes mellitus (T1DM) and T2DM have examined the potential utility, benefits, and side effects of agents that augment insulin secretion after oral ingestion of nutrients in comparison with intravenous nutrient delivery, the so-called incretins. Two families of incretin-like substances are now approved for use in adults. Glucagon-like peptide-1 (GLP-1) or agents that bind to its receptor (exenatide, Byetta) or agents that inhibit its destruction [dipeptidyl peptidase-IV (DPP-IV) inhibitors, Vildagliptin] improve insulin secretion, delay gastric emptying, and suppress glucagon secretion while decreasing food intake without increasing hypoglycemia. Pramlintide, a synthetic amylin analog, also decreases glucagon secretion and delays gastric emptying, improves hemoglobin A1c (HbA1C), and facilitates weight reduction without causing hypoglycemia. We review the historical discovery of these agents, their physiology [corrected] and their current applications. Remarkably, only one or two studies have been reported in children. Pediatricians caring for children with T1DM and T2DM should become familiar with these agents and investigate their applicability, as they seem likely to enhance our...Continue Reading

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Citations

Oct 24, 2007·Archives of Disease in Childhood·Thomas DanneOlga Kordonouri
Aug 13, 2010·Critical Care : the Official Journal of the Critical Care Forum·Gabriel A MecottMarc G Jeschke
Feb 6, 2008·Protein Expression and Purification·Eva Bosse-DoeneckeRainer Rudolph
Nov 4, 2016·Pediatric Diabetes·Fida Bacha, Sara Klinepeter Bartz
Mar 30, 2017·Journal of Diabetes Science and Technology·Lisa J UnderlandRubina A Heptulla
Dec 19, 2008·Pediatric Research·Vandana S Raman, Rubina A Heptulla
Dec 6, 2014·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Christelle Le FollBarry E Levin
Jun 21, 2013·Current Opinion in Pediatrics·Jamie R Wood, Janet Silverstein
Apr 29, 2008·Arquivos brasileiros de endocrinologia e metabologia·Mônica de A Lima Gabbay
Nov 16, 2018·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Samie SabetLaura J Chalmers
Mar 20, 2015·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Christelle Le FollBarry E Levin

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