Treatment of Type 1 Diabetic Patients with Glucagon-Like Peptide-1 (GLP-1) and GLP-1R Agonists

被引:46
作者
Kielgast, Urd [1 ,2 ]
Holst, Jens J. [3 ]
Madsbad, Sten [1 ,2 ]
机构
[1] Hvidovre Univ Hosp, Dept Endocrinol, DK-2650 Hvidovre, Denmark
[2] Univ Copenhagen, Dept Endocrinol, Hvidovre, Denmark
[3] Univ Copenhagen, Panum Inst, Dept Biomed Sci, Copenhagen, Denmark
关键词
Type; 1; diabetes; GLP-1; Glucagon; beta-cell mass; Residual insulin secretion; Glycemic control;
D O I
10.2174/157339909789804413
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
GLP-1 (glucagon-like peptide-1) is a peptide hormone secreted from endocrine cells in the intestinal mucosa in response to meals. The major effects of GLP-1 are to increase glucose-induced insulin secretion and reduce glucagon release, but GLP-1 also inhibits gastric emptying rate and reduces appetite and bodyweight in obese subjects. In vivo studies using animal models of type 2 diabetes and in vitro studies using human islet cells have suggested that GLP-1 or GLP-1 analogues are also able to increase beta-cell mass, but in animal models of type 1 diabetes, there is much less evidence for a beta-cell preserving effect. This review summarizes the present knowledge of GLP-1 and its analogues regarding its role as a possible treatment in patients with type 1 diabetes. The studies that address the effect of GLP-1 and GLP-1 analogues on beta-cell mass in both type 2 and type 1 diabetes, as well as the potential of GLP-1 as an adjuvant therapy in islet cell transplantation, will be reviewed. Suggestions for future studies of GLP-1 treatment in type 1 diabetes may include early treatment in order to preserve beta-cell mass and prolong the remission period, but should also take a potential insulin sparing effect and changes in the risk of hypoglycemia into account.
引用
收藏
页码:266 / 275
页数:10
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