Another class of medications associated with weight loss and improved blood sugar control is the sodium glucose cotransporter 2 (SGLT-2) inhibitors. Because this is impractical as a therapeutic option for type 2 diabetes, it was necessary to develop longer-acting derivatives of GLP-1. Glucagon-like peptide 1 receptor (GLP-1R) agonists and dipeptidyl peptidase-4 inhibitors (DPP-4i) are clinically used against type 2 diabetes. Patients with high-titer exenatide antibodies exhibited a smaller decrease in A1C (−0.5%) compared with patients with low-titer antibodies (−1.0%). The glucagon receptor is a central target in novel and anticipated type 2 diabetes therapies, and hemodynamic consequences of glucagon signaling have therefore become increasingly important. The sodium-glucose cotransporter 2 (SGLT-2) inhibitors are a novel class of glucose-lowering drugs which act by inhibiting the reabsorption of filtered glucose from the kidneys. © 2011 by the American Diabetes Association. [7] A JAMA article meta-analysis in 2018 (covering studies concerning GLP-1 agonists, DPP-4 inhibitors, and SGLT2 inhibitors) showed GLP-1 agonists were associated with lower stroke risk than controls. GLP-1 RAs are very effective at lowering blood sugar levels. 2). Glucagon is a 29 amino acid hormone used as a diagnostic aid in radiologic exams to temporarily inhibit the movement of the gastrointestinal tract and to treat severe hypoglycemia. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. The safety and efficacy of liraglutide have been well detailed in the phase 3 Liraglutide Effect and Action in Diabetes (LEAD) trials (27–32). Change in body weight with long-acting GLP-1 receptor agonists across the clinical trials (24,32,36–39,41). As a drug class, long-acting GLP-1 receptor agonists increase glycemic control in patients with type 2 diabetes with a low risk of hypoglycemia because of their glucose-dependent mechanism of action. 3). In addition to their effects on glycemic control and body weight, the long-acting GLP-1 receptor agonists have been shown to reduce SBP in patients with type 2 diabetes, ranging from −4.7 mmHg after 15 weeks with exenatide LAR (33) to −6.7 mmHg after 26 weeks with liraglutide (30) (Table 2). You can help Wikipedia by expanding it. The effects on body weight were similar with both liraglutide and exenatide (−3.24 vs. −2.87 kg, respectively), with a similar proportion of patients losing weight in both treatment groups (78% with liraglutide vs. 76% with exenatide) (32). CNS, central nervous system; GABA, γ-aminobyteric acid. Victoza summary of product characteristics [Internet]. GLP-1 agonists have been shown to improve insulin secretion, decrease glucagon production, increase satiety, and help decrease food intake. Two classes of incretin-based therapy have been developed to overcome the clinical limitations of native GLP-1: GLP-1 receptor agonists (e.g., liraglutide and exenatide), which exhibit increased resistance to DPP-4 degradation and thus provide pharmacological levels of GLP-1, and DPP-4 inhibitors (e.g., sitagliptin, vildagliptin, saxagliptin), which reduce endogenous GLP-1 degradation, thereby providing physiological levels of GLP-1. Because of its half-life of 2.4 h, exenatide is recommended for twice-daily dosing. Patients switched from exenatide to liraglutide also experienced a reduction in rates of hypoglycemia from 2.6 episodes/patient-year at week 26 to 1.3 episodes/patient-year at week 40. 1). In particular, the insulinoptropic action of glucose-dependent insulinotropic polypeptide is lost in patients with type 2 diabetes. Change in A1C with long-acting GLP-1 receptor agonists across the clinical trials (24,32,36–39,41). Byetta summary of product characteristics: US [Internet]. In particular, incretin-based therapies (GLP-1 receptor agonists, specifically) can help meet these new targets by offering weight reduction, blood pressure reduction, and reduced hypoglycemia in addition to glycemic control. received research support from Novo Nordisk and GlaxoSmithKline; received advisory board/consultant/speaker honoraria from Novo Nordisk, GlaxoSmithKline, and Roche; served on the speakers’ bureaus of Merck, Novo Nordisk, and GlaxoSmithKline; served on advisory boards for GlaxoSmithKline, Roche, Novo Nordisk, and Merck; served as a consultant for GlaxoSmithKline, Roche, Novo Nordisk, and Sankyo; and attended speakers' bureaus for GlaxoSmithKline, Novo Nordisk, Merck, and Sankyo. Roche faces long delay for diabetes drug taspoglutide [Internet]. As seen in the original DURATION (Diabetes Therapy Utilization: Researching Changes in A1C, Weight and Other Factors Through Intervention with Exenatide Once Weekly) -1 study, incidence of hypoglycemia was low and limited to patients who received exenatide in combination with a sulfonylurea. In patients with type 2 diabetes, the incretin effect is reduced or, in some cases, absent (8). However, it has been shown that, after administration of pharmacological levels of GLP-1, the insulin secretory function can be restored in this population (9), and thus GLP-1 has become an important target for research into new therapies for type 2 diabetes. The Congress and the publication of this supplement were made possible in part by unrestricted educational grants from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, Ethicon Endo-Surgery, Generex Biotechnology, F. Hoffmann-La Roche, Janssen-Cilag, Johnson & Johnson, Novo Nordisk, Medtronic, and Pfizer. Medications which affect glucagon secretion . In addition, a significantly greater reduction in fasting plasma glucose was observed with exenatide LAR versus twice-daily exenatide (−2.3 vs. −1.4 mmol/L for exenatide LAR and twice-daily exenatide, respectively; P < 0.0001). *P < 0.01 vs. comparator; **P < 0.001; ***P < 0.0001; ###P < 0.0001 vs. placebo. Clinical trial results have demonstrated that exenatide, when used in combination with selected oral antidiabetic drugs, effectively reduces A1C by −0.4 to −1.5% in patients with type 2 diabetes inadequately controlled on metformin with or without a sulfonylurea (20–24). At the time of writing, Roche had suspended the development of taspoglutide, currently in phase 3 trials, because of the high discontinuation rates as a result of gastrointestinal tolerability and serious hypersensitivity reactions (33). DPP-4 inhibitors are usually prescribed for people with type 2 diabetes who have not responded well to drugs such as metformin and sulphonylureas. SGLT-2 inhibitors are a new class of drugs for Type 2 diabetes with novel mechanism of action. Clinical data have revealed that these therapies improve glycemic control while reducing body weight (GLP-1 receptor agonists, specifically) and systolic blood pressure (SBP) in patients with type 2 diabetes. Glucagon is available under the following different brand names: Glucagen, Glucagon Emergency Kit, and GlucaGen HypoKit. The lower dose of insulin may be insufficient to suppress lipolysis and ketogenesis. [citation needed] Diabetes is associated with both acute pancreatitis and pancreatic cancer. Two drug classes have been developed: glucagon-like peptide (GLP)-1 receptor agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors. Glucagon is synthesized in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered by the addition of the gene for Glucagon.Glucagon is a single-chain polypeptide that contains 29 amino acid residues and has a molecular weight of 3483.The empirical formula is C153H225N43O49S. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. The fungal bisanthroquinone skyrin, isolated from Talaromyces wortmannin, inhibits glucagon -stimulated cAMP formation and glucose output from rat and human hepatocytes. For example, the American Diabetes Association (ADA) defines multiple goals of therapy that include A1C <7.0% and SBP <130 mmHg and no weight gain (or, in the case of obese subjects, weight loss) (5). This class of medications is used for the treatment of type 2 diabetes. Glucagon receptor is a class B G-protein coupled receptor (GPCR) that mediates the glucagon-induced release of glucose from the liver into the bloodstream. This drug class has also been demonstrated to promote weight loss and reduce SBP, which could be of benefit to patients with type 2 diabetes, reducing their cardiovascular risk. Antibody formation was very low in patients treated with once-weekly GLP-1 receptor agonists. Individuals switching from twice-daily exenatide to exenatide LAR displayed further improvements in glycemic control, achieving the same reduction in A1C from baseline (−2.0% at week 52) as subjects who had been treated only by exenatide LAR. The rate of minor hypoglycemia was very low in these trials (incidence ranged from 0.03 to 0.6 events/patient/year with the different treatment groups [excluding those using liraglutide in combination with a sulfonylurea]). While some recent studies have not found that these drugs can cause either pancreatitis or cancer,[5] a 2017 study found that recent prescription of incretins was associated with an increased risk of pancreatic cancer over non-insulin anti diabetic drugs (NIADs). Glucagon increases blood glucose levels, and DPP-4 inhibitors reduce glucagon and blood glucose levels. Glucagon-like peptide-1 agonists may be used alone in patients intolerant of metformin or in combination with metformin, thiazolidinediones, and sulfonylureas (or in any combination therereof). Reduction in A1C was significantly greater with exenatide LAR versus twice-daily exenatide (−1.9 vs. −1.5%, respectively; P = 0.0023), and a significantly greater proportion of subjects reached the A1C target of ≤7.0% with exenatide LAR versus twice-daily exenatide (77 vs. 61%, respectively; P = 0.0039) (Supplementary Fig. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a group of drugs used to treat type 2 diabetes. In addition to liraglutide and exenatide, there are several once-weekly GLP-1 receptor agonists in development: exenatide long-acting release (LAR) (Eli Lilly/Amylin), taspoglutide (Roche), albiglutide (GlaxoSmithKline), and LY2189265 (Eli Lilly) (Supplementary Table 1). No other potential conflicts of interest relevant to this article were reported. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. The development of new therapies for the treatment of type 2 diabetes that, in addition to maintaining glycemic control, could reduce body weight and hypoglycemia risk (3,4), may help with patient management. Furthermore, SGLT2 is expressed in pancreatic α-cells, and SGLT2 inhibitors promote glucagon secretion. Two different classes of diabetes drugs , DPP-4 inhibitors and incretin mimetics, act in response to the presence of meals to stimulate the increase of insulin and to inhibit the release of glucagon. Two GLP-1 receptor agonists are licensed at present in Europe, the U.S., and Japan: exenatide (Byetta, Eli Lilly) (17) and liraglutide (Victoza, Novo Nordisk) (18). Both drugs were well tolerated, with only mild-to-moderate side effects observed. GLP-1 has multiple physiological effects that make it an attractive candidate for type 2 diabetes therapy. The A1C and fasting plasma glucose reductions seen in the first 30 weeks were maintained throughout an extension study (22 weeks), where patients either switched from twice-daily exenatide to once-weekly exenatide LAR or continued exenatide LAR treatment (35). Glucagon prompts gluconeogenesis and glucose efflux from the liver. Nausea was reported as the most common adverse effect with both treatments, although it was less frequent and less persistent with liraglutide. Formulary Information 2). Data from published clinical trials using long-acting GLP-1 receptor agonists (liraglutide, exenatide LAR, albiglutide, taspoglutide, LY2189265) reveal that reductions in A1C from baseline range from −0.87 to −1.9% (31,33,35–39) (Fig. The proportion of patients reporting minor hypoglycemic events was low in both treatment arms (0 vs. 1.1% of the study population for exenatide LAR and twice-daily exenatide, respectively); reports of minor hypoglycemia were increased in patients taking a sulfonylurea concomitantly (14.5 vs. 15.4% of the study population for exenatide LAR and twice-daily exenatide, respectively). [1][2] One of their advantages over older insulin secretagogues, such as sulfonylureas or meglitinides, is that they have a lower risk of causing hypoglycemia. Glucagon’s effects on hemodynamic parameters, most notably heart rate and cardiac contractility, are often overlooked. Available from, Bergenstal R, Wysham C, Yan P, Macconell L, Malloy J, Porter L. DURATION-2: exenatide once weekly demonstrated superior glycaemic control and weight reduction compared to sitagliptin or pioglitazone after 26 weeks of treatment. Absolute benefits are determined by individual risk profiles of patients, with clear implications for clinical practice, as reflected in the BMJ Rapid Recommendations directly informed by this systematic review. GlucaGen se presenta en un vial con glucagón, polvo blanco y estéril, con una jeringa desechable que contiene el disolvente. Insulin and glucagon are key hormones controlling blood glucose levels. Concomitant use of dipeptidyl-peptidase-4 inhibitors is not recommended because they have a similar basis of action. A larger proportion of patients developed antibodies to exenatide (after 26 weeks: 113/185 patients; 61%), and this is likely to be due to the lower sequence identity of exenatide with native GLP-1. Glucagon receptor is a 62 kDa protein activated by glucagon. Conclusions: In patients with type 2 diabetes, SGLT-2 inhibitors and GLP-1 receptor agonists reduced cardiovascular and renal outcomes, with notable differences in benefits and harms. El polvo está compactado. For the purposes of this review, we refer to “short-acting” GLP-1 receptor agonists as those agents having duration of action of <24 h and “long-acting” as those agents with duration of action >24 h (Table 1). This review considers the efficacy and safety of both the short- and long-acting GLP-1 receptor agonists. Gastrointestinal effects, including nausea and vomiting, appear to be the most frequently reported adverse effect seen with the long-acting GLP-1 receptor agonists (Table 2). No major hypoglycemic events were reported. Furthermore, incidence of hypoglycemia is relatively low with these treatments (except when used in combination with a sulfonylurea) because of their glucose-dependent mechanism of action. As reported previously, the greatest proportion of patients reporting minor hypoglycemic events was when adding treatments to a sulfonylurea background (24,27,31,32). Clinical data have revealed that these therapies improve glycemic control while reducing body weight (GLP-1 receptor agonists, specifically) and systolic blood pressure (SBP) in patients with type 2 diabetes. Drug images are also included. Glucagon for Injection, for intravenous or intramuscular use, is a gastrointestinal motility inhibitor that is produced by solid phase peptide synthesis. Summary of efficacy and tolerability with long-acting GLP-1 receptor agonists. Antagonizing the glucagon receptor is expected to result in reduced hepatic glucose overproduction, leading to overall glycemic control. A 14-week LEAD-6 extension study was also completed, in which patients, already randomized to liraglutide, stayed on liraglutide, and those on exenatide switched to once-daily liraglutide (34). The most common adverse effects seen with exenatide LAR versus twice-daily exenatide were nausea (26.4 vs. 34.5%, respectively) and injection site pruritus (17.6 vs. 1.4%, respectively). Glucagon-like peptide-1 receptor agonists, also known as GLP-1 receptor agonists or incretin mimetics, are agonists of the GLP-1 receptor. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Byetta summary of product characteristics: Europe [Internet]. Further reductions in fasting plasma glucose (−0.9 mmol/L), body weight (−0.9 kg), and SBP (−3.8 mmHg) were also seen after the switch to liraglutide. Short- and long-acting GLP-1 receptor agonists. Results from this trial revealed that exenatide LAR improved glycemic control significantly more than twice-daily exenatide. 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diabetes, Four weeks of near-normalisation of blood glucose improves the insulin response to glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide in patients with type 2 diabetes, Normalization of fasting hyperglycaemia by exogenous glucagon-like peptide 1 (7-36 amide) in type 2 (non-insulin-dependent) diabetic patients, Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and beta-cell function in type 2 diabetes: a parallel-group study, Glucagon-like peptide 1 induces pancreatic beta-cell proliferation via transactivation of the epidermal growth factor receptor, Glucagon-like peptide-1 promotes islet cell growth and inhibits apoptosis in Zucker diabetic rats, Similar elimination rates of glucagon-like peptide-1 in obese type 2 diabetic patients and healthy subjects, Glucagon-like peptide-1 infusion must be maintained for 24 h/day to obtain acceptable glycemia in type 2 diabetic patients who are poorly controlled on sulphonylurea treatment, Dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus, Effects of exenatide (exendin-4) on glycemic control over 30 weeks in patients with type 2 diabetes treated with metformin and a sulfonylurea, Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes, Effects of exenatide (exendin-4) on glycemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes, Exenatide versus insulin glargine in patients with suboptimally controlled type 2 diabetes: a randomized trial, Exenatide once weekly versus twice daily for the treatment of type 2 diabetes: a randomised, open-label, non-inferiority study, Molecular, pharmacological and clinical aspects of liraglutide, a once-daily human GLP-1 analogue, Liraglutide,1a once-daily human GLP-1 analogue, added to a sulphonylurea over 26 weeks produces greater improvements in glycemic and weight control compared with adding rosiglitazone or placebo in subjects with type 2 diabetes (LEAD-1 SU), Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes: the LEAD (liraglutide effect and action in diabetes)-2 study, Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono): a randomised, 52-week, phase III, double-blind, parallel-treatment trial, Efficacy and safety of the human glucagon-like peptide-1 analog liraglutide in combination with metformin and thiazolidinedione in patients with type 2 diabetes (LEAD-4 Met+TZD), Liraglutide vs insulin glargine and placebo in combination with metformin and sulfonylurea therapy in type 2 diabetes mellitus (LEAD-5 met+SU): a randomised controlled trial, Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6), Switching to once-daily liraglutide from twice-daily exenatide further improves 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weight in subjects with type 2 diabetes, The effect of LY2189265 (GLP-1 analogue) once weekly on HbA1c and beta cell function in uncontrolled type 2 diabetes mellitus: the EGO study analysis, Pivotal Role of Timely Basal Insulin Replacement After Metformin Failure in Sustaining Long-Term Blood Glucose Control at a Target in Type 2 Diabetes, Insulin: Potential Negative Consequences of Early Routine Use in Patients With Type 2 Diabetes, Institutional Subscriptions and Site Licenses, Special Podcast Series: Therapeutic Inertia, Special Podcast Series: Influenza Podcasts, http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc11-s231/-/DC1, http://creativecommons.org/licenses/by-nc-nd/3.0/, http://www.ema.europa.eu/humandocs/PDFs/EPAR/byetta/emea-combined-h698en.pdf, http://www.ema.europa.eu/humandocs/PDFs/EPAR/victoza/H-1026-PI-en.pdf, http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021773s9s11s18s22s25lbl.pdf, 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Glucagon maintains glucose homeostasis during the fasting state by promoting hepatic gluconeogenesis and glycogenolysis. SGLT-2 inhibitors block reabsorption of glucose in the kidneys, leading to excretion of glucose in urine. After taspoglutide treatment, for example, nausea and vomiting were usually resolved within 1 day, and subsequent taspoglutide administrations were less likely to induce nausea (39). Exenatide was generally well tolerated, with mild-to-moderate gastrointestinal effects being the most common adverse effect (20–23). Meta-analysis of glucagon-like peptide 1 receptor agonist (GLP1-RA) and sodium-glucose cotransporter-2 inhibitor (SGLT2i) trials on hospitalization for heart failure (HHF) stratified by drug class. Hyperglucagonemia and/or an elevated glucagon-to-insulin ratio have been reported in diabetic patients and animals. LY2409021 decreases serum glucose by preventing glucagon receptor activation and alleviating excess gluconeogenesis. The molecular basis for the delayed absorption of the once-daily human GLP-1 analogue, liraglutide. Further benefits of liraglutide treatment included a reduced number of hypoglycemic events and higher overall treatment satisfaction. 1):A164, Fiercebiotech. Generic. Furthermore, gastric emptying is delayed (10) and food intake is decreased after GLP-1 administration. In addition to its role in the regulation of glucose metabolism, glucagon has been described to promote ketosis in the fasted state. The safety and efficacy of once-weekly exenatide LAR (2 mg) versus twice-daily exenatide (10 μg) was evaluated in a phase 2/3 randomized open-label trial over 30 weeks involving 295 patients naive to drug therapy or on one or more oral antidiabetic drugs (24). This publication is based on the presentations at the 3rd World Congress on Controversies to Consensus in Diabetes, Obesity and Hypertension (CODHy). Insulin binding to its receptor promotes glucose disposal in peripheral tissues and suppresses hepatic glucose output. At present, many available treatments for type 2 diabetes fail to maintain glycemic control in the longer term because of gradual disease progression as β-cell function declines. Shorter-acting agonists of the GLP-1 receptor are particularly effective at lowering post-meal glucose spikes, whereas longer-acting GLP-1 agonists have more balanced effects on lowering post-meal and fasting glucose Check mild interactions to serious contraindications for up to 30 drugs, herbals, and supplements at a time. Neuroprotective Effects of Dipeptidyl Peptidase-4 (DPP-4) Inhibitors and Glucagon Like Peptide-1 (GLP-1) Receptor Agonists (GLP-1RA) DPP-4 inhibitors represent novel antidiabetic treatment strategies by reducing glycaemia, sustaining insulin levels, and reducing glucagon levels in type 2 diabetes mellitus (Ahrén et al., 2004). Writing assistance was provided by Watermeadow Medical, funded by Novo Nordisk A/S. Across these studies, body weight was seen to decrease in a dose-dependent manner; treatment with 10 μg exenatide, as an add-on to metformin, resulted in the greatest weight loss (−2.8 kg) in patients previously treated with metformin alone (21). Currently, there are no data directly comparing the clinical efficacy of the long-acting GLP-1 receptor agonists (liraglutide, exenatide LAR, albiglutide, taspoglutide, LY2189265). As a result, a greater proportion of patients with type 2 diabetes reached the ADA A1C target (≤7.0%) (3) with liraglutide compared with exenatide (54 vs. 43%; P = 0.0015) (32). GLP-1 has a short duration of action, so to overcome this limitation several modifications either in the drug or the formulations are being developed. Liraglutide is a GLP-1 analog that shares 97% sequence identity to native GLP-1 (25). Their effect on insulin and glucagon levels has recently been studied but is not fully explained. Head-to-head clinical trial data suggest that long-acting GLP-1 receptor agonists produce superior glycemic control when compared with their short-acting counterparts. The efficacy of liraglutide is not impacted in subjects positive for anti-liraglutide antibodies: a pooled analysis [article online]. This class of drugs is commonly called glucagon-like peptide 1 (GLP-1) agonists. The results achieved with long-acting GLP-1 receptor agonists appear to be superior to those achieved with short-acting GLP-1 receptor agonists, with greater improvements in glycemic control after once-daily liraglutide treatment compared with twice-daily exenatide. The number of patients experiencing nausea peaked during the initial weeks of treatment (0–8 weeks) but decreased thereafter. 17 Furthermore, pasireotide has been shown to reduce glucagon secretion from pancreatic α‐cells. © 2021 by the American Diabetes Association. Patients with inactivating mutations in their insulin receptors experience severe insulin resistance and uncontrolled diabetes. The incretin effect, responsible for 50–70% of total insulin secretion after oral glucose administration, is defined as the difference in insulin secretory response from an oral glucose load compared with intravenous glucose administration (6) (Supplementary Fig. Available from, Amylin/Eli Lilly. Drug Interaction Checker. Following a switch to liraglutide after 26 weeks, patients previously treated with exenatide still exhibited anti-exenatide antibodies after treatment weeks 40 (49.7%) and 78 (17.5%). Careful consideration should be given to the selection of therapies for managing type 2 diabetes. Furthermore, exenatide LAR provided better glycemic control than exenatide with comparable weight loss. 1). Enter multiple addresses on separate lines or separate them with commas. GLP-1 Receptor Agonists for Type 2 Diabetes Currently Available in the U.S. GLP-1 agonists are a class of antidiabetic agents that mimic the actions of the glucagon-like peptide. Indeed, guidelines have been developed that support the consensus that blood pressure, weight reduction, and avoidance of hypoglycemic events should be targeted in type 2 diabetes management alongside glycemic targets. There are two naturally occurring incretin hormones that play a role in the maintenance of glycemic control: glucose-dependent insulinotropic polypeptide and GLP-1, both of which have a short half-life because of their rapid inactivation by DPP-4 (7). Drug Drug Description; Glucagon: A form of recombinant glucagon used to treat hypoglycemia in diabetes mellitus and as a part of gastrointestinal imaging procedures. These preclinical results indicate that GLP-1 could be beneficial in treating patients with type 2 diabetes. This drug article relating to the gastrointestinal system is a stub. The efficacy and tolerability of the DPP-4 inhibitors have been reviewed elsewhere (16).
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