Pleiotropic effects of insulin and GLP-1 receptor agonists: Potential benefits of the association

Diabetes & Metabolism
B Cariou

Abstract

The combination of basal insulin and glucagon-like peptide-1 receptor agonists (GLP-1RAs) is an emerging option for patients with type 2 diabetes (T2D). GLP-1RAs have been shown to improve glycaemic control with a low risk of hypoglycaemia and to promote body weight loss. However, GLP-1 receptors (GLP-1Rs) are widely expressed in extrapancreatic tissues and could sustain pleiotropic actions of GLP-1RAs beyond glycaemic control. The underlying molecular mechanisms maintaining these extrapancreatic actions of GLP-1 are complex, and involve GLP-1R signalling in both the brain and several peripheral tissues. The present review focuses specifically on the role of GLP-1RAs in the cardiovascular system and liver. Preclinical data in rodents and pilot studies in humans suggest that GLP-1RAs may have potential beneficial effects on heart function, blood pressure, postprandial lipaemia, liver steatosis and non-alcoholic steatohepatitis (NASH). Long-term studies are now warranted to determine the safety and clinical relevance of the association between insulin and GLP-1RAs in T2D.

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Citations

Mar 20, 2018·Current Opinion in Lipidology·Laurent Yvan-Charvet, Bertrand Cariou
Feb 8, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Maria J Peláez-JaramilloCarlos O Mendivil
Jul 31, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Sanjay KalraManilka Sumanatilleke
Jun 22, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Markolf HanefeldJochen Seufert
Oct 27, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Luciano ZenariAnnunziata Lapolla

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