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Novel Approaches to the Treatment of Type 2 Diabetes
* To whom correspondence should be addressed. E-mail: stonge{at}cop.ufl.edu.
The emergence of the glucoregulatory hormone, glucagon-like peptide-1, has expanded our understanding of glucose homeostasis. The glucoregulatory actions of glucagon-like peptide-1 include enhancement of glucose-dependent insulin secretion, suppression of inappropriately elevated glucagon secretion, slowing of gastric emptying, and reduction of food intake. Two approaches have been developed to potentiate the effects of glucagon-like peptide-1 in those with type 2 diabetes. The glucagon-like peptide-1 analogs, such as exenatide, and dipeptidyl peptidase-IV inhibitors, such as sitagliptin, are currently available whereas others are in the final stages of development. These agents effectively reduce hemoglobin A1c while providing the other benefits associated with increased glucagon-like peptide-1. They also offer the potential to preserve the
First published on January 6, 2009, doi:10.1177/0897190008326578 |
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-cell function. The effects on cardiovascular disease, if any, are unknown. Based on the current evidence, these agents represent viable second- and third-line options in the management of type 2 diabetes.