Topic:	diabetes (dm)
Title:	Coming of Age for the Incretins.
Author:	Holst, J.J.; Deacon, C.F.
Source:	IN: LeRoith, D.; Vinik, A., eds. Controversies in Treating Diabetes: Clinical and Research Aspects. Totowa, NJ: Humana Press.2008. pp 269-290.
Abstract:	This chapter about the incretin hormones, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide-1 (GLP-1), is from a book that addresses diabetes controversies, specifically in the etiology and management of the disease. The authors of this chapter consider the role of these incretin hormones in postprandial insulin secretion, which is insulin secretion that happens after a meal. They note that, in type 2 diabetes, the incretin effect is severely reduced. Substitution therapy with GLP-1 can result in glucose-induced insulin secretion, up-regulation of insulin and other beta-cell genes, stimulation of beta-cell proliferation, neogenesis and inhibition of beta-cell destruction, inhibition of glucagon secretion, inhibition of gastric emptying, and inhibition of appetite and food intake. However, GLP-1 is rapidly destroyed by an enzyme called dipeptidyl peptidase IV (DPP-IV), so any drug therapy that uses GLP-1 will require orally active DPP-IV inhibitors. The authors describe the animal studies and clinical trials that have focused on these incretins. One GLP-1 receptor activator (Byetta) and one of the DPP-IV inhibitors are already on the market and other compounds are in late phases of development or awaiting approval. 110 references.
Format:	Book Chapter
Language:	English.
Major Keywords:	Diabetes Mellitus. Controversial Therapy. Patient Care Management. Postprandial Hyperglycemia. Drug Therapy. Pathophysiology. Incretin Mimetics.
Minor Keywords:	DPP-IV Inhibitors. Gastrointestinal Motility. Gastric Emptying. Exenatide. Glucagon. Insulin. Physiology. Drug Effects. Clinical Trials.
Publication Number:	DMBK13267
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