• Medicina clinica · Jan 2014

    Review

    [Modulation of the incretin effect in the treatment of diabetes].

    • Josep Vidal.
    • Servicio de Endocrinología y Nutrición, Hospital Clínic, Barcelona, España. Electronic address: jovidal@clinic.ub.es.
    • Med Clin (Barc). 2014 Jan 1; 143 Suppl 2: 8118-11.

    AbstractModulation of the incretin effect has opened up a new strategy in the treatment of diabetes mellitus type 2 (DM2). To date, this physiological mechanism has been boosted in two ways: firstly, by pharmacological inhibition of the enzyme that physiologically degrades glucagon-like peptide-1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 (DPP4); secondly, through the development of GLP-1 agonists (GLP-1a) that are resistant to the action of DPP-4. Several clinical trials have shown the clinical superiority of GLPa, which seems to be linked to higher circulating levels of GLP-1. On the other hand, this higher efficacy also seems to be associated with the higher rate of adverse effects associated with aGLP-1 therapy compared with DPP-4 inhibition. These and other differentiating characteristics of the two drug families will determine the choice of drug therapy in the personalized treatment of hyperglycemia in patients with DM2.

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