Tip 2 Diyabet Tedavisinde Kullanılan Exendin-4 ve Exendin-4’ün Alternatif Uygulama Yolları İçin Güncel Yaklaşımlar

Year 2022, Volume: 47 Issue: 2, 265 - 280, 01.08.2022

Merve Çelik Tekeli Yeşim Aktaş Nevin Çelebi

Abstract

Diabetes is a chronic disease due to impaired glucose metabolism
and usually presents with uncontrolled hyperglycemia or persistently
high blood sugar levels. According to the tenth edition of the
international Diabetes Federation, 10% of global health
expenditures ($ 966 billion) are spent on diabetes. in turkey, the
prevalence of diabetes is 15%, showing the fastest increase among
european countries. type 2 diabetes is associated with abnormal
insulin secretion or chronic insulin resistance, causing
desensitization of the glucose uptake cells to insulin activity.
incretin-based therapies have come to the fore in the treatment of
type 2 diabetes in recent years. exendin-4, which is widely used in
incretin-based therapies, binds to GlP-1 receptors with high
affinity, causing glucose-dependent insulin secretion in the body,
delaying gastric emptying, suppressing glucagon release and appetite.
Also, exendin-4 increases cell proliferation and inhibits apoptotic
pathways in β-cells. commercial products of exendin-4 are Byetta®
which is administered twice daily and long-acting Byderuon™ which
is administered once weekly via parenteral route. the presence of
drawbacks of parenteral administration such as problems in patient
compliance and feeling of pain due to injection led researchers to
search alternative administration routes such as oral, pulmonary,
transdermal, ocular, nasal, vaginal and rectal routes. in this review,
exendin-4’s properties, mechanism of action, therapeutic efficacy,
new approaches and studies on alternative delivery routes of
exendin-4 are mentioned.

Keywords

exendin-4, diabetes, oral route, pulmonary route, transdermal route, nanocarriers

References

• Ahn, S., Lee, I. H., Lee, E., Kim, H., Kim, Y. C., and Jon, S. (2013). Oral delivery of an anti-diabetic peptide drug via conjugation and complexation with low molecular weight chitosan, Journal of Controlled Release, 170(2), 226-232. doi: 10.1016/j.jconrel. 2013.05.031