PMID- 22127767
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20240330
IS  - 1869-6961 (Electronic)
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Linking)
VI  - 2
IP  - 1
DP  - 2011 Mar
TI  - Glucagon-like peptide-1 (GLP-1) receptor agonists: Differentiating the new 
      medications.
PG  - 29-39
LID - 10.1007/s13300-010-0013-5 [doi]
AB  - INTRODUCTION: Glucagon-like peptide-1 (GLP-1) has been the focus of considerable 
      research activity in the treatment of type 2 diabetes mellitus (T2DM) because the 
      incretin effect is significantly reduced or absent in individuals with T2DM. 
      Thus, pharmacologic efforts to develop medications that mimic the actions of 
      GLP-1 have become a target for improving or reversing chronic hyperglycemia. Two 
      GLP-1 receptor agonists are commercially available: exenatide twice daily 
      (b.i.d.) and liraglutide once daily (q.d.). Targeted and individualized 
      intensification of diabetes management can best be accomplished with a thorough 
      understanding of these new medications. METHODS: Information was gathered through 
      a search of MEDLINE and PubMed for GLP-1 and glycemic management in patients with 
      type 2 diabetes. RESULTS: Activation of the GLP-1 receptors on the beta-cells 
      results in enhanced levels of insulin biosynthesis, beta-cell proliferation, 
      resistance to beta-cell apoptosis, and enhanced beta-cell survival in both humans and 
      rodents; yet, the risk of hypoglycemia is minimized because insulin production 
      and exocytosis occurs in a glucose-dependent manner. The efficacy and safety of 
      the two commercially available GLP-1 receptor agonists, liraglutide and 
      exenatide, in managing postprandial glycemia have been well documented in 
      numerous clinical trials, in which reductions in glycosylated hemoglobin (HbA1c) 
      levels of -0.79% to -1.12% have been demonstrated. Weight reduction/maintenance 
      and improvements in blood pressure and lipidemia have also been reported. 
      CONCLUSION: Because GLP-1 receptor agonists work in a glucose-dependent manner, 
      they are likely to reduce hyperglycemia safely, without a marked fluctuation 
      toward hypoglycemia. In the process of acutely restoring beta-cell function, GLP-1 
      agonists may allow patients to achieve HbA(1c) <7% without experiencing weight 
      gain or hypoglycemia. The ability of GLP-1 receptor agonists to improve blood 
      pressure and postprandial lipidemia in the context of weight neutrality or weight 
      loss may have the potential to ameliorate some of the cardiovascular risks 
      observed in patients with T2DM.
FAU - Unger, Jeffrey R
AU  - Unger JR
AD  - Loma Linda University School of Medicine, Loma Linda, USA.
FAU - Parkin, Christopher G
AU  - Parkin CG
LA  - eng
PT  - Journal Article
DEP - 20110118
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC3124643
EDAT- 2011/12/01 06:00
MHDA- 2011/12/01 06:01
PMCR- 2011/01/18
CRDT- 2011/12/01 06:00
PHST- 2010/11/11 00:00 [received]
PHST- 2011/12/01 06:00 [entrez]
PHST- 2011/12/01 06:00 [pubmed]
PHST- 2011/12/01 06:01 [medline]
PHST- 2011/01/18 00:00 [pmc-release]
AID - 13 [pii]
AID - 10.1007/s13300-010-0013-5 [doi]
PST - ppublish
SO  - Diabetes Ther. 2011 Mar;2(1):29-39. doi: 10.1007/s13300-010-0013-5. Epub 2011 Jan 
      18.