Pappachan JM, Raveendran A, Sriraman R. Incretin manipulation in diabetes management. World J Diabetes 2015; 6(6): 774-781 [PMID: 26131320 DOI: 10.4239/wjd.v6.i6.774]
Corresponding Author of This Article
Dr. Joseph M Pappachan, MD, MRCP (London), Department of Endocrinology and Diabetes, New Cross Hospital, the Royal Wolverhampton Hospital NHS Trust, Wolverhampton Road, WV10 0QP Wolverhampton, United Kingdom. drpappachan@yahoo.co.in
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jun 25, 2015; 6(6): 774-781 Published online Jun 25, 2015. doi: 10.4239/wjd.v6.i6.774
Incretin manipulation in diabetes management
Joseph M Pappachan, AV Raveendran, Rajagopalan Sriraman
Joseph M Pappachan, Department of Endocrinology and Diabetes, New Cross Hospital, the Royal Wolverhampton Hospital NHS Trust, WV10 0QP Wolverhampton, United Kingdom
AV Raveendran, Department of Medicine, Kottayam Medical College, Kerala 686008, India
Rajagopalan Sriraman, Department of Endocrinology, Lincoln County Hospital, LN2 5QY Lincoln, United Kingdom
Author contributions: Pappachan JM and Sriraman R conceived the idea; Pappachan JM and Raveendran AV wrote the initial draft of the paper; all authors contributed to literature search and final preparation of the manuscript.
Conflict-of-interest: Dr. Sriraman R received lecture fees from Astra Zeneca, Novo Nordisk and Novo Nordisk Local Access Advisory Board, and sponsorship from Nono Nordisk to attend international conferences. The other authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Joseph M Pappachan, MD, MRCP (London), Department of Endocrinology and Diabetes, New Cross Hospital, the Royal Wolverhampton Hospital NHS Trust, Wolverhampton Road, WV10 0QP Wolverhampton, United Kingdom. drpappachan@yahoo.co.in
Telephone: +44-1922-721172 Fax: +44-1922-721172
Received: January 7, 2015 Peer-review started: January 8, 2015 First decision: March 6, 2015 Revised: March 14, 2015 Accepted: April 16, 2015 Article in press: April 20, 2015 Published online: June 25, 2015
Abstract
Incretin-based therapies have revolutionized the medical management of type 2 diabetes mellitus (T2DM) in the 21st century. Glucagon-like peptide-1 (GLP-1) suppresses appetite and gastric motility, and has trophic effects on pancreas, cardio-protective and renal effects. GLP-1 analogues and dipeptidyl peptidase-4 inhibitors form the incretin-based therapies. Significant reduction of hemoglobin A1c when used as monotherapy and in combination regimens, favorable effects on body weight, and low risk of hypoglycemia are their unique therapeutic benefits. Their safety and tolerability are comparable to other anti-diabetic medications. Concern about elevated risk of pancreatitis has been discarded by two recent meta-analyses. This article discusses the therapeutic manipulation of incretin system for the management of T2DM.
Core tip: Development of multiple pharmaceutical agents by the manipulation of incretin hormone system provided the global scientific fraternity several drugs for the management of type 2 diabetes mellitus (T2DM) in recent years. These agents, the glucagon-like peptide-1 analogues and dipeptidyl peptidase-4 inhibitors, form the incretin-based therapies that benefited T2DM patients with significant reduction of hemoglobin A1c, low risk of hypoglycemia, favorable effects on management of overweight and obesity, and enhanced efficacy in combination regimens for glycemic management with other anti-diabetics. Two recent meta-analyses discarded the concern about elevated pancreatitis risk. The article discusses the incretin-based therapies for the management of T2DM.
