| Title : The physiologic role of incretin hormones: clinical applications - Cefalu_2010_J.Am.Osteopath.Assoc_110_S8 |
| Author(s) : Cefalu WT |
| Ref : J Am Osteopath Assoc , 110 :S8 , 2010 |
| Abstract : Treatment of patients with type 2 diabetes mellitus (T2DM) traditionally has involved a progression of phases, from conventional lifestyle interventions and monotherapy, to combination therapy involving oral agents, to insulin initiation and its use either alone or with oral pharmacotherapy. Currently, the need for antidiabetic therapies with fewer adverse effects (eg, weight gain, reduced rates of hypoglycemia) is unmet. In addition, most treatments fail to adequately control postprandial hyperglycemia. Traditional options have generally been directed at the "insulin demand" aspect and have targeted insulin secretion or insulin resistance in peripheral tissues. Only recently have agents been available to address the "glucose supply" aspect that leads to fasting hyperglycemia in patients with T2DM. Incretin-based therapies, however, address both aspects. Two classes of incretin-directed therapies are available and work by either increasing endogenous levels of glucagon-like peptide-1 (GLP-1) (ie, dipeptidyl peptidase-4 inhibitors) or by mimicking the activity of endogenous GLP-1 (ie, GLP-1 agonists). These therapies treat the key metabolic abnormalities associated with T2DM but do so with reduced rates of hypoglycemia and do not promote weight gain as compared with conventional therapies. |
| ESTHER : Cefalu_2010_J.Am.Osteopath.Assoc_110_S8 |
| PubMedSearch : Cefalu_2010_J.Am.Osteopath.Assoc_110_S8 |
| PubMedID: 20382839 |
| Title : Redefining treatment success in type 2 diabetes mellitus: Comprehensive targeting of core defects - Cefalu_2009_Cleve.Clin.J.Med_76 Suppl 5_S39 |
| Author(s) : Cefalu WT , Richards RJ , Melendez-Ramirez LY |
| Ref : Cleve Clin J Med , 76 Suppl 5 :S39 , 2009 |
| Abstract : Despite advances in diagnosis and treatment, type 2 diabetes mellitus (T2DM), overweight/obesity, cardiovascular disease, and their sequelae are major public health burdens worldwide. The understanding of the pathophysiology of T2DM has traditionally emphasized decreased insulin secretion and increased insulin resistance, but evolving concepts now include the role of incretin hormones in disease progression. A comprehensive approach to managing patients with T2DM requires targeting both the fundamental defects of the disease and its comorbidities, including the sequelae of nonoptimal control of blood glucose, blood pressure, body weight, and lipids. Newer antidiabetes agents, such as the glucagon-like peptide-1 (GLP-1) receptor agonists and the dipeptidyl peptidase-4 (DPP-4) inhibitors, address fundamental defects related to glycemic control in T2DM and may have potential effects on other markers of cardiovascular risk. A redefinition of treatment success may be warranted as more data become available. |
| ESTHER : Cefalu_2009_Cleve.Clin.J.Med_76 Suppl 5_S39 |
| PubMedSearch : Cefalu_2009_Cleve.Clin.J.Med_76 Suppl 5_S39 |
| PubMedID: 19952302 |