Role of Incretin Therapies in the Management of Type 2 Diabetes Mellitus

REVIEW ARTICLE


Erin L St Onge^1, Shannon A Miller² and Katherine Vogel Anderson¹

Affiliations: ¹University of Florida College of Pharmacy, Orlando Campus, Florida; ²Pharmacotherapy Faculty, Florida Hospital Family Practice Residency, Florida and ³University of Florida College of Pharmacy, Gainesville Campus, Florida

ABSTRACT

Although a variety of medications with varied mechanisms of action are available for the treatment of type 2 diabetes mellitus, a significant number of patients remain uncontrolled. The use of metformin, sulfonylureas, and insulin may be limited due to adverse effects and precautions in certain patient populations. The incretin-based therapies, GLP-1 analogs, and DPP-4 inhibitors give clinicians additional options in treating diabetic patients. By replacing GLP-1 or inhibiting its breakdown, the beneficial effects of GLP-1 are able to persist. The GLP-1 stimulates insulin secretion, slows gastric emptying, decreases glucagon, improves ß-cell function, and reduces appetite. Several GLP-1 analogs and DPP-4 inhibitors have been approved by the FDA or are in various stages of development. The introduction of some of the newer agents may provide for enhanced patient compliance. Additional studies are necessary to determine the long-term safety and efficacy of these agents; however, these incretin-based therapies offer several advantages over existing therapy options.


Keywords: incretin, type 2 diabetes, GLP-1 analog, DPP-4 inhibitor, treatment

Correspondence: Erin L St Onge, Assistant Dean and Clinical Assistant Professor, University of Florida College of Pharmacy, Orlando Campus, 2725 S. Binion Rd. Apopka, FL 32703, USA. Tel: +1 407 884 2034/ext. 141; Fax: +1 407 814 6185; e-mail: stonge@cop.ufl.edu