Incretins in the treatment of type 2 diabetes mellitus

Abstract

Incretin hormones are defined as intestinal hormones released in response to nutrient ingestion. The incretin hormones include glucagon-like peptide (GLP-l) and glucose dependent polypeptide (GIP). GLP-l secreted by L cells from ileum and colon while GIP is maily produced K cells from the upper small intestine. Incretin hormones potentiate the glucose induced insulin response from pancreatic beta cells. With their non weight-gain, non hypoglycemic attributes and with positive effects on beta cell mass and lifetime as proven by animal experiments, parenterally used GLP-1 agonists of Exenatide and Liraglutide have emerged among medications used for the treatment of early stage diabetes. Dipeptidyl peptidase-4 inhibitors are effective either as a single or combination therapy in lowering glycated hemoglobin, fasting and postprandial glucose levels, with a low incidence of hypoglycemia and no weight gain.

Keywords

• Diabetes mellitus
• Incretins
• Exenatide
• Liraglutide
• GLP-1 analogues
• DPP-4 inhibitors

Tip 2 diabetes mellitus tedavisinde inkretinler

Abstract

Bağırsaktan, besin alımı sonucu salgılanan hormonlar inkretin hormonlar olarak tanımlanmaktadır. İnkretin hormonlar glukagon benzeri peptit-1 (GLP-l) ve glukoz bağımlı insülinotropik peptit (GIP) olarak adlandırılır. GLP-l, ileum ve kolonda yer alan L hücreleri, GIP ise bağırsağın daha üst bölgelerinde yerleşik K hücrelerinden salgılanır. İnkretin hormonlar pankreas beta hücrelerinden glukoz ile uyarılan insülin salgılanmasını artırır. Parenteral yolla kullanılan GLP-l agonistleri olan Eksenatid ve Liraglutide kilo aldırmayıcı, hipoglisemi yapmayıcı ve hayvan deneylerinde ispatlanan beta hücre kütlesi ve ömrü üzerindeki olumlu etkileriyle, erken dönem diyabet tedavisinde kullanacağımız ilaçlar arasında yer almışlardır. Dipeptidil peptidaz-4 (DPP-4)inhibitörleri tek başına veya kombinasyon tedavisinde HbAlC'yi düşürmede, açlık ve tokluk kan şekerleri seviyelerini düzenlemede etkili gözlenmişlerdir, ancak hipoglisemi ve kilo kaybı etkileri düşük izlenmiştir. 

Keywords

• Diyabetes mellitus
• İnkretinler
• Eksenatid
• Liraglutide
• GLP-l analogları
• DPP-4 inhibitörleri

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