Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes
Catherine A Schnabel, Matthew Wintle, Orville KoltermanAmylin Pharmaceuticals, Inc, 9360 Towne Centre Drive, Suite 110, San Diego, CA 92121, USAAbstract: Interventional studies have demonstrated the impact of hyperglycemia on the development of vascular complications associated with type 2 diabetes,...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2006-03-01
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| Series: | Vascular Health and Risk Management |
| Online Access: | https://www.dovepress.com/metabolic-effects-of-the-incretin-mimetic-exenatide-in-the-treatment-o-peer-reviewed-article-VHRM |
| _version_ | 1828302344143503360 |
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| author | Catherine A Schnabel Matthew Wintle Orville Kolterman |
| author_facet | Catherine A Schnabel Matthew Wintle Orville Kolterman |
| author_sort | Catherine A Schnabel |
| collection | DOAJ |
| description | Catherine A Schnabel, Matthew Wintle, Orville KoltermanAmylin Pharmaceuticals, Inc, 9360 Towne Centre Drive, Suite 110, San Diego, CA 92121, USAAbstract: Interventional studies have demonstrated the impact of hyperglycemia on the development of vascular complications associated with type 2 diabetes, which underscores the importance of safely lowering glucose to as near-normal as possible. Among the current challenges to reducing the risk of vascular disease associated with diabetes is the management of body weight in a predominantly overweight patient population, and in which weight gain is likely with many current therapies. Exenatide is the first in a new class of agents termed incretin mimetics, which replicate several glucoregulatory effects of the endogenous incretin hormone, glucagon-like peptide-1 (GLP-1). Currently approved in the US as an injectable adjunct to metformin and/or sulfonylurea therapy, exenatide improves glycemic control through multiple mechanisms of action including: glucose-dependent enhancement of insulin secretion that potentially reduces the risk of hypoglycemia compared with insulin secretagogues; restoration of first-phase insulin secretion typically deficient in patients with type 2 diabetes; suppression of inappropriately elevated glucagon secretion to reduce postprandial hepatic output; and slowing the rate of gastric emptying to regulate glucose appearance into the circulation. Clinical trials in patients with type 2 diabetes treated with subcutaneous exenatide twice daily demonstrated sustained improvements in glycemic control, evidenced by reductions in postprandial and fasting glycemia and glycosylated hemoglobin (HbA1c) levels. Notably, improvements in glycemic control with exenatide were coupled with progressive reductions in body weight, which represents a distinct therapeutic benefit for patients with type 2 diabetes. Acute effects of exenatide on beta-cell responsiveness along with significant reductions in body weight in patients with type 2 diabetes may have a positive impact on disease progression and potentially decrease the risk of associated long-term complications.Keywords: exenatide, type 2 diabetes, incretin, incretin mimetic |
| first_indexed | 2024-04-13T13:35:33Z |
| format | Article |
| id | doaj.art-2402f274ce984b0597fb04b3195fb08f |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-04-13T13:35:33Z |
| publishDate | 2006-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-2402f274ce984b0597fb04b3195fb08f2022-12-22T02:44:48ZengDove Medical PressVascular Health and Risk Management1178-20482006-03-01Volume 269771404Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetesCatherine A SchnabelMatthew WintleOrville KoltermanCatherine A Schnabel, Matthew Wintle, Orville KoltermanAmylin Pharmaceuticals, Inc, 9360 Towne Centre Drive, Suite 110, San Diego, CA 92121, USAAbstract: Interventional studies have demonstrated the impact of hyperglycemia on the development of vascular complications associated with type 2 diabetes, which underscores the importance of safely lowering glucose to as near-normal as possible. Among the current challenges to reducing the risk of vascular disease associated with diabetes is the management of body weight in a predominantly overweight patient population, and in which weight gain is likely with many current therapies. Exenatide is the first in a new class of agents termed incretin mimetics, which replicate several glucoregulatory effects of the endogenous incretin hormone, glucagon-like peptide-1 (GLP-1). Currently approved in the US as an injectable adjunct to metformin and/or sulfonylurea therapy, exenatide improves glycemic control through multiple mechanisms of action including: glucose-dependent enhancement of insulin secretion that potentially reduces the risk of hypoglycemia compared with insulin secretagogues; restoration of first-phase insulin secretion typically deficient in patients with type 2 diabetes; suppression of inappropriately elevated glucagon secretion to reduce postprandial hepatic output; and slowing the rate of gastric emptying to regulate glucose appearance into the circulation. Clinical trials in patients with type 2 diabetes treated with subcutaneous exenatide twice daily demonstrated sustained improvements in glycemic control, evidenced by reductions in postprandial and fasting glycemia and glycosylated hemoglobin (HbA1c) levels. Notably, improvements in glycemic control with exenatide were coupled with progressive reductions in body weight, which represents a distinct therapeutic benefit for patients with type 2 diabetes. Acute effects of exenatide on beta-cell responsiveness along with significant reductions in body weight in patients with type 2 diabetes may have a positive impact on disease progression and potentially decrease the risk of associated long-term complications.Keywords: exenatide, type 2 diabetes, incretin, incretin mimetichttps://www.dovepress.com/metabolic-effects-of-the-incretin-mimetic-exenatide-in-the-treatment-o-peer-reviewed-article-VHRM |
| spellingShingle | Catherine A Schnabel Matthew Wintle Orville Kolterman Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes Vascular Health and Risk Management |
| title | Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes |
| title_full | Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes |
| title_fullStr | Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes |
| title_full_unstemmed | Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes |
| title_short | Metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes |
| title_sort | metabolic effects of the incretin mimetic exenatide in the treatment of type 2 diabetes |
| url | https://www.dovepress.com/metabolic-effects-of-the-incretin-mimetic-exenatide-in-the-treatment-o-peer-reviewed-article-VHRM |
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