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Reshaping diabetes care: the fundamental role of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists in clinical practice.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Umpierrez, Guillermo E. Meneghini, Luigi
Description	Country affiliation: United States Author Affiliation: Umpierrez GE ( Department of Medicine, Division of Endocrinology and Metabolism, Emory University School of Medicine, Atlanta, Georgia 30303, USA. geumpie@emory.edu)
Abstract	OBJECTIVE: To update clinicians on the most recent safety and efficacy data on current incretin-based strategies for the treatment of type 2 diabetes (T2D). METHODS: Title searches were conducted in the Pubmed database to identify literature pertaining to the safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 (DPP-4) inhibitors. Product-specific title searches included the terms exenatide, liraglutide, linagliptin, saxagliptin, sitagliptin, and vildagliptin. RESULTS: The recent literature has introduced us to newer DPP-4 inhibitors and longer-acting GLP-1RAs, updated meta-analyses assessing the safety and efficacy of incretin-based therapies, and studies exploring the use of incretin-based treatments in broader clinical settings such as combination therapy with insulin. Meta-analyses have demonstrated placebo-adjusted glycated hemoglobin (HbA1c) reductions of ~1% with GLP-1RAs and 0.6 to 0.8% with DPP-4 inhibitors and have suggested cardioprotective effects such as reduction of cardiovascular events and improvement of lipid profile. As a class, these agents have consistently demonstrated low risks of hypoglycemia relative to other agents. CONCLUSION: Incretin-based therapies are characterized by an overall favorable safety profile and weight effect, a low risk of hypoglycemia, and clinically meaningful improvements in HbA1c. Based on an expanding and favorable literature describing their use in various patient populations, the guidelines of the American Association of Clinical Endocrinologists and the recently updated guidelines from the American Diabetes Association assign these agents a central role in the treatment of T2D.
File Format	HTM / HTML
ISSN	1530891X
Issue Number	4
Volume Number	19
e-ISSN	19342403
Journal	Endocrine Practice
Language	English
Publisher	American Association of Clinical Endocrinologists
Publisher Date	2013-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Endocrinology Diabetes Mellitus, Type 2 Drug Therapy Dipeptidyl-peptidase Iv Inhibitors Therapeutic Use Hypoglycemic Agents Receptors, Glucagon Agonists Metabolism Glucagon-like Peptide-1 Receptor Hemoglobin A, Glycosylated Humans Journal Article Research Support, Non-u.s. Gov't Review
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Endocrinology

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