Overview of Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Patients with Type 2 Diabetes... [including commentary by Raymond Plodkowski].

BACKGROUND: It is estimated that 29.1 million people or 9.3% of the US population have diabetes, which contributes to considerable medical and financial burden. Type 2 diabetes mellitus is characterized by insulin resistance and insulin secretion impairment leading to hyperglycemia. The presence of...

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Publicado en:American Health & Drug Benefits Vol. 10; no. 4; pp. 178 - 189
Autores principales: Lingjet Tran, Kelvin, Young In Park, Pandya, Shalin, Muliyil, Navin John, Jensen, Brandon David, Huynh, Kovin, Quang T. Nguyen
Formato: commentary research tables/charts Journal Article
Publicado: Amplity Health Jun2017
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Overview of Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Patients with Type 2 Diabetes... [including commentary by Raymond Plodkowski].
      aug:
        au:
          Lingjet Tran, Kelvin
          Young In Park
          Pandya, Shalin
          Muliyil, Navin John
          Jensen, Brandon David
          Huynh, Kovin
          Quang T. Nguyen
        affil: Resident, Department of Internal Medicine, Valley Hospital Medical Center, Las Vegas, NV
      sug:
        subj:
          Glucagon-Like Peptide-1 Receptor Agonists Administration and Dosage
          Diabetes Mellitus, Type 2 Drug Therapy
          Human
          Medical Practice, Evidence-Based
          Decision Making, Clinical
          Comparative Studies
          Metformin Administration and Dosage
          Dipeptidyl Peptidase 4 Inhibitors Administration and Dosage
          Sulfonylurea Compounds Administration and Dosage
          Incretins Administration and Dosage
          Glucagon-Like Peptide-1 Receptor Agonists Adverse Effects
          Glucose
          Insulin
          Glucagon
          Appetite
          Gastrointestinal System Drug Effects
          Administration, Oral
          Injections, Subcutaneous
      ab: BACKGROUND: It is estimated that 29.1 million people or 9.3% of the US population have diabetes, which contributes to considerable medical and financial burden. Type 2 diabetes mellitus is characterized by insulin resistance and insulin secretion impairment leading to hyperglycemia. The presence of insulin resistance is strongly correlated with obesity. OBJECTIVE: This article reviews the available glucagon-like peptide-1 (GLP-1) receptor agonists and their role in the management of patients with diabetes, to help guide the selection of the most suitable agent for the individualized treatment of patients with type 2 diabetes. DISCUSSION: This article reviews the evidence from phase 3 clinical trials for each of the 5 GLP-1 receptor agonists by comparing them against one another and with other existing therapies, including metformin, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sulfonylureas. Incretin-based therapies have emerged as attractive agents for the treatment of type 2 diabetes. They target the GLP-1 hormone, which is partly responsible for insulin release and for attenuating hyperglycemia during meals (ie, the incretin effect). The 2 classes of incretin-based therapy currently available are GLP-1 receptor agonists and DPP-4 inhibitors, which prevent the breakdown of GLP-1. Both classes are attractive options, given their glucose- lowering effects without the adverse effects of hypoglycemia and weight gain. The different mechanisms of action of these therapies result in generally greater efficacy with GLP-1 receptor agonists, albeit at the expense of slightly increased gastrointestinal symptoms. These agents exert their effects by improving glucose-dependent insulin release, suppressing glucagon release, suppressing hepatic glucose output, and decreasing the rate of gastric emptying, thereby reducing appetite. Currently, 5 GLP-1 receptor agonists are available, including exenatide, liraglutide, albiglutide, dulaglutide, and lixisenatide; semaglutide may soon become available as the newest agent. With the exception of the investigational oral semaglutide, which has shown promising results, the other 5 agents are administered as subcutaneous injections, at different dosing intervals. CONCLUSION: Currently, 5 GLP-1 receptor agonists are available for use in the United States. Although they are all in the same drug class, some significant differences exist among the various GLP-1 receptor agonists. The choice of a specific GLP-1 receptor agonist will depend on the patient preferences, potential adverse effects, and cost.
      pubtype: Periodical
      doctype:
        commentary
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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