Incretins are a group of gastrointestinal hormones that cause an increase in the amount of insulin released from the beta cells of the islets of Langerhans after eating, even before blood glucose levels become elevated. They also slow the rate of absorption of nutrients into the blood stream by reducing gastric emptying and may directly reduce food intake. As expected, they also inhibit glucagon release from the alpha cells of the Islets of Langerhans. The two main candidate molecules that fulfill criteria for an incretin are glucagon-like peptide-1 (GLP-1) and Gastric inhibitory peptide (also known as: glucose-dependent insulinotropic polypeptide or GIP). Both GLP-1 and GIP are rapidly inactivated by the enzyme dipeptidyl peptidase-4 (DPP-4).
GLP-1 (7-36) amide is not very useful for treatment since it must be administered by continuous subcutaneous infusion. Several long-lasting analogs that have insulinotropic activity have been developed and two, exenatide (Byetta) and liraglutide (Victoza), have been approved for use in the U.S. The main disadvantage of these GLP-1 analogs is that they must be administered by subcutaneous injection.
Another approach is to inhibit the enzyme that inactivates GLP-1 and GIP, DPP-4.
Several DPP-4 inhibitors that can be taken orally as a tablet have been developed.
Few available in India are
Sitagliptin
Vildagliptin
Saxagliptin
The main advantage of DPP4 Inhibitors are that their action is glucose dependent. They do not reduce sugar when it is normal or low.
ReplyDeleteAnimal studies have shown beta cell neogenesis. Iam doing a secret analysis of their effect in LADA. Seems to be good.
well all the very best madam!! i thoughts secrets should not be divulged over the net. with your permission can i delete the secret from the net??
ReplyDelete