Drugs for Diabetes

Part 6 GLP-1 Receptor Agonists

Claire McDougall; Gerard A McKay; Miles Fisher

Disclosures

Br J Cardiol. 2011;18(4):167-169. 

In This Article

Abstract and Introduction

Abstract

The glucagon-like peptide-1 (GLP-1) receptor agonists are a new class of injected drugs for the treatment of type 2 diabetes. They mimic the action of GLP-1 and increase the incretin effect in patients with type 2 diabetes, stimulating the release of insulin. They have additional effects in reducing glucagon, slowing gastric emptying, and inducing satiety. In clinical practice they are associated with significant reductions in glycosylated haemoglobin (HbA1c), weight loss and a low risk of hypoglycaemia. Beneficial effects have also been observed on blood pressure and lipids. The possibility of cardiovascular benefit is now being formally examined in large randomised-controlled trials with primary cardiovascular end points

Introduction

The cardiovascular morbidity and mortality associated with diabetes are well established, so much so that type 2 diabetes has been described as a cardiovascular disease presenting as a metabolic disorder. Patients with type 2 diabetes are particularly at risk for atherosclerosis; consequently glycaemic therapies with ancillary vascular benefits are particularly useful, and the pleiotropic effects of glucose-lowering medications are of interest with regards to their effects on markers of cardiovascular health. Glucagon-like peptide-1 (GLP-1) receptors are widely expressed in a number of tissues including the myocardium and cardiovasculature, and GLP-1 appears to have a range of neurotrophic, neuroprotective and cardioprotective effects. As a consequence there may be potential therapeutic benefit from these drugs.

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