Incretin-based therapies: new treatments for type 2 diabetes in the new millennium

摘要

The advent of ‘incretin?based therapies’ – GLP?1 agonists and dipeptidyl?peptidase?4 inhibitors – which result in improvements in glycemic control comparable to those with existing oral hypoglycemic agents, and potentially improve cardiovascular and pancreatic β?cell function, represents a major therapeutic advance in the management of type 2 diabetes. Gastrointestinal adverse effects occur commonly with GLP?1 agonists, and rarely with DPP?4 inhibitors, but are dose?dependent and usually transient. The low risk of hypoglycemia, and beneficial or neutral effects on body weight, render GLP?1 agonists and DPP?4 inhibitors suitable alternatives to insulin secretagogues and insulin in overweight and elderly patients. Incretin?based therapies also improve quality of life in patients with type 2 diabetes, and may be cost?effective in the long term.