By Stephen Gough
This concise instruction manual offers an outline of incretin-based treatments and counsel for incorporating them into the remedy of variety 2 diabetes. Chapters contain landmark scientific trials and overseas therapy guidance so one can replace readers with all significant advances within the box. a fantastic source for doctors that deal with sufferers with kind 2 diabetes in medical institution and medical settings.
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Extra resources for Handbook of Incretin-based Therapies in Type 2 Diabetes
Sample text
The fusion to albumin and the amino acid substitution both result in a longer half-life and, thus, the need for less-frequent dosing. Albiglutide has a molecular weight of approximately 70,000 g/mol. Maximum concentrations of albiglutide were reached 3–5 days after a single 30 mg subcutaneous dose. Steady-state concentrations are achieved after 4–5 weeks of once-weekly administration. The elimination half-life is approximately 5–7 days, making it suitable for once-weekly administration [21]. Albiglutide has been studied as monotherapy and add-on therapy to metformin, sulfonylureas, thiazolidinediones, insulin glargine, and 36 • HA ND B O O K O F I N C R E T IN � B A S E D T H E R AP IE S IN T YP E 2 D IA B E T E S varying combinations of these agents [22–27].
1996;271(3 Pt 1):E458-E464. 37 Holst JJ, Deacon CF. Glucagon-like peptide-1 mediates the therapeutic actions of DPP-IV inhibitors. Diabetologia. 2005;48:612-615. 38 Hjøllund KR, Deacon CF, Holst JJ. Dipeptidyl peptidase-4 inhibition increases portal concentrations of intact glucagon-like peptide-1 (GLP-1) to a greater extent than peripheral concentrations in anaesthetised pigs. Diabetologia. 2011;54:2206-2208. 39 Imeryuz N, Yegen BC, Bozkurt A, Coskun T, Villanueva-Penacarrillo ML, Ulusoy NB. Glucagonlike peptide-1 inhibits gastric emptying via vagal afferent- mediated central mechanisms.
The physiological and pharmacological actions of GLP-1 were used to develop two drug classes of incretin-based therapies: GLP-1 receptor agonists (GLP-1 RA) for injectable therapy and orally active DPP-4 inhibitors. GLP-1 RA stimulate insulin secretion and inhibit glucagon secretion in a glucose-dependent manner. They also have extrapancreatic effects; the most important for type 2 diabetes therapy are the slowing of gastric emptying, a stimulation of sensations of satiety and fullness by direct action on the central nervous system, and body weight reduction [1].