Dipeptidyl Peptidase IV Inhibitors as second-line therapeutics in type 2 Diabetes
March 27, 2010
| Abstract Title: | Dipeptidyl Peptidase IV Inhibitors as second-line therapeutics in type 2 Diabetes |
| Authors: | Narcisa Mihailescu, Maria Puschita |
| Affiliation: | “Vasile Goldis” Western University Arad, Romania |
| Abstract text: | Introduction. Current anti-hyperglycemic medications are unable to address all of the underlying pathologic and physiologic defects in patients with type 2 Diabetes. It has been known for many years that administration of an oral glucose challenge elicits a stronger insulin response than an equivalent intravenous glucose challenge. This incretin effect was attributed to the insulin tropic action of gut hormones: GLP1 (glucagon like peptid1) and GIP (glucose-dependent insulin tropic polypeptide). The incretin hormones are released in response to food ingestion to stimulate insulin secretion and in the case of GLP1, to inhibit glucagon secretion, thereby decreasing glucose production by the liver in a counter regulatory manner. 70% of post-glucose insulin secretion is due to the incretin effect. In type 2 diabetes that effect are greatly diminished. There are 2 different strategies for enhancing GLP1 action in diabetes: extending the activity of GLP1 in the form of synthetic long-acting GLP1 analogues and inhibiting DPP4 (dipeptidyl peptidase-4) to prevent the inactivation of endogenous GLP1 and GIP. Objectives: Authors are proposing to evaluate the efficacy and safety of sitagliptin in patients with T2DM not adequately controlled with metformin (2000-2500 mg/d); primary endpoint: HbA1C change after 32 weeks, secondary endpoint: fasting plasma glucose, postprandial glucose, body weight change, hypoglycemia, adverse events. Results aimed to provide data to help clinicians decide to use this novel agents. |
| Keywords: | incretin effect, GLP1, GIP, DPP4, sitagliptin |
| Presentation type: | Oral |
| Correspondence: | no. 18 Abatorului St., Arad, Romania |
| Email: | narcisamihailescu@yahoo.com |
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