EFFICACY AND SAFETY OF INCRETIN THERAPY IN TYPE 2 DIABETES MELLITUS: THE SYSTEMATIC REVIEW
Keywords:
Diabetes Mellitus, HbA1c, Hyperglycemia, Incretin TherapyAbstract
Hyperglycemia is the key sign of type 2 diabetes, which is a metabolic disorder characterised by an inadequate production of insulin as well as resistance to the action of insulin. As longitudinal studies of type 2 diabetes continue to provide evidence linking improved glycemic control with a reduction in the rates of diabetes-associated complications, there is a considerable interest in the therapy of type 2 diabetes, with a focus on the development and use of new agents that exhibit improved efficacy and safety in comparison to currently available medicines. Clinical use of incretin-based medicines is growing steadily, and there are numerous additional products being developed at this time. The individual mechanisms by which dual agonism of both GLP-1 and GIP receptors may improve glycemic control require further investigation. We conducted post hoc exploratory analyses of biomarkers associated with pancreatic beta-cell function and insulin sensitivity in order to investigate the mechanisms by which tirzepatide led to greater reductions of hyperglycemia than a selective GLP-1 receptor agonist. According to the findings of this paper, a dose of 15 milligrams of tizepatide was superior in reducing HbA1c levels, despite the fact that it induced higher levels of gastrointestinal side effects.
References
International Diabetes Federation. Diabetes. Brussels: IDF; 2017.
Fauci AS, Jameson JL, Kasper D, et al. Harrison’s Principles of Internal Medicine 19th Edition. New York: McGraw-Hill Education; 2018.
Drucker DJ, Sherman SI, Gorelick FS, Bergenstal RM, Sherwin RS, Buse JB. Incretin-based therapies for the treatment of type 2 diabetes: evaluation of the risks and benefits. Diabetes Care. Februari 2010;33(2):428–33.
Artasensi A, Pedretti A, Vistoli G, Fumagalli L. Type 2 Diabetes Mellitus: A Review of Multi-Target Drugs. Molecules. April 2020;25(8).
Neumiller JJ. Incretin-based therapies. Med Clin North Am. Januari 2015;99(1):107–29.
Tasyurek HM, Altunbas HA, Balci MK, Sanlioglu S. Incretins: their physiology and application in the treatment of diabetes mellitus. Diabetes Metab Res Rev. Juli 2014;30(5):354–71.
Robertson C. Incretin-Related Therapies in Type 2 Diabetes: A Practical Overview. Diabetes Spectr [Internet] 1 Februari 2011;24(1):26–35. Tersedia pada: https://doi.org/10.2337/diaspect.24.1.26
Gilbert MP, Pratley RE. GLP-1 Analogs and DPP-4 Inhibitors in Type 2 Diabetes Therapy: Review of Head-toHead Clinical Trials. Front Endocrinol (Lausanne). 2020;11:178.
Frías JP, Davies MJ, Rosenstock J, Pérez Manghi FC, Fernández Landó L, Bergman BK, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. Agustus 2021;385(6):503–15.
Rosenstock J, Wysham C, Frías JP, Kaneko S, Lee CJ, Fernández Landó L, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet (London, England). Juli 2021;398(10295):143–55.
Del Prato S, Kahn SE, Pavo I, Weerakkody GJ, Yang Z, Doupis J, et al. Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial. Lancet (London, England). November 2021;398(10313):1811–24.
Frias JP, Nauck MA, Van J, Kutner ME, Cui X, Benson C, et al. Efficacy and safety of LY3298176, a novel dual GIP and GLP-1 receptor agonist, in patients with type 2 diabetes: a randomised, placebo-controlled and active comparator-controlled phase 2 trial. Lancet (London, England). November 2018;392(10160):2180–93.
Czech MP. Insulin action and resistance in obesity and type 2 diabetes. Nat Med. Juli 2017;23(7):804–14.
Padhi S, Nayak AK, Behera A. Type II diabetes mellitus: a review on recent drug based therapeutics. Biomed Pharmacother. November 2020;131:110708.
Chellappan DK, Yap WS, Bt Ahmad Suhaimi NA, Gupta G, Dua K. Current therapies and targets for type 2 diabetes mellitus. Panminerva Med. September 2018;60(3):117–31.
Sun J, Cui J, He Q, Chen Z, Arvan P, Liu M. Proinsulin misfolding and endoplasmic reticulum stress during the development and progression of diabetes. Mol Aspects Med. April 2015;42:105–18.
Thomas MK, Nikooienejad A, Bray R, Cui X, Wilson J, Duffin K, et al. Dual GIP and GLP-1 Receptor Agonist Tirzepatide Improves Beta-cell Function and Insulin Sensitivity in Type 2 Diabetes. J Clin Endocrinol Metab. Januari 2021;106(2):388–96.
Perreault L, Skyler JS, Rosenstock J. Novel therapies with precision mechanisms for type 2 diabetes mellitus. Nat Rev Endocrinol. Juni 2021;17(6):364–77.
Vangipurapu J, Stančáková A, Kuulasmaa T, Kuusisto J, Laakso M. Both fasting and glucose-stimulated proinsulin levels predict hyperglycemia and incident type 2 diabetes: a population-based study of 9,396 Finnish men. PLoS One. 2015;10(4):e0124028.
Ahrén B. Type 2 diabetes, insulin secretion and beta-cell mass. Curr Mol Med. Mei 2005;5(3):275–86.
Patel K, Levesque K, Mark V, Pierini E, Rojas B, Ahlers M, et al. Proinsulin associates with poor β-cell function, glucose-dependent insulinotropic peptide, and insulin resistance in persistent type 2 diabetes after Roux-en-Y gastric bypass in humans. J Diabetes. Januari 2020;12(1):77–86.
Smith SA, Porter LE, Biswas N, Freed MI. Rosiglitazone, but not glyburide, reduces circulating proinsulin and the proinsulin:insulin ratio in type 2 diabetes. J Clin Endocrinol Metab. Desember 2004;89(12):6048–53.
Lebovitz HE. Incretin-based therapies: facing the realities of benefits versus side effects. Vol. 15, Diabetes technology & therapeutics. 2013. hal. 909–13.
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