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Incretin-based medications (GLP-1 receptor agonists, DPP-4 inhibitors) as a means to avoid hypoglycaemic episodes

Farngren, Johan LU and Ahrén, Bo LU (2019) In Metabolism: Clinical and Experimental 99. p.25-31
Abstract

Hypoglycaemia is common in both type 1 and type 2 diabetes and has both acute and long-term consequences. Therefore, a key to proper glucose-lowering therapy in diabetes is to avoid or prevent hypoglycaemia. Incretin therapy (DPP-4 inhibitors and GLP-1 receptor agonists) offers an advantage in this respect, because it reduces glucose with a low risk of hypoglycaemia, both in monotherapy and in combination with other therapies. The reason for this low risk of hypoglycaemia is the glucose dependency of action of incretin therapy and the sustainment of glucose counter-regulatory hormone responses to hypoglycaemia, in particular the glucagon response. Incretin therapy is also associated with a low risk of hypoglycaemia in patient groups... (More)

Hypoglycaemia is common in both type 1 and type 2 diabetes and has both acute and long-term consequences. Therefore, a key to proper glucose-lowering therapy in diabetes is to avoid or prevent hypoglycaemia. Incretin therapy (DPP-4 inhibitors and GLP-1 receptor agonists) offers an advantage in this respect, because it reduces glucose with a low risk of hypoglycaemia, both in monotherapy and in combination with other therapies. The reason for this low risk of hypoglycaemia is the glucose dependency of action of incretin therapy and the sustainment of glucose counter-regulatory hormone responses to hypoglycaemia, in particular the glucagon response. Incretin therapy is also associated with a low risk of hypoglycaemia in patient groups which are especially vulnerable and susceptible for hypoglycaemia, e.g., subjects with renal impairment, elderly subjects and subjects with on-going insulin therapy. This review summarizes how incretin therapy may meet the challenges of hypoglycaemia and suggests that incretin therapy is a therapy of choice to avoid hypoglycaemia, both in the general diabetes population and in subjects with increased risk or vulnerability for hypoglycaemia.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
DPP-4 inhibitors, GLP-1 receptor agonists, Hypoglycaemia, Incretin therapy, Type 2 diabetes
in
Metabolism: Clinical and Experimental
volume
99
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:85068498160
ISSN
0026-0495
DOI
10.1016/j.metabol.2019.06.016
language
English
LU publication?
yes
id
20b9fd32-53ee-40e4-a307-265f18cb8e3f
date added to LUP
2019-07-16 08:51:38
date last changed
2019-08-14 04:41:50
@article{20b9fd32-53ee-40e4-a307-265f18cb8e3f,
  abstract     = {<p>Hypoglycaemia is common in both type 1 and type 2 diabetes and has both acute and long-term consequences. Therefore, a key to proper glucose-lowering therapy in diabetes is to avoid or prevent hypoglycaemia. Incretin therapy (DPP-4 inhibitors and GLP-1 receptor agonists) offers an advantage in this respect, because it reduces glucose with a low risk of hypoglycaemia, both in monotherapy and in combination with other therapies. The reason for this low risk of hypoglycaemia is the glucose dependency of action of incretin therapy and the sustainment of glucose counter-regulatory hormone responses to hypoglycaemia, in particular the glucagon response. Incretin therapy is also associated with a low risk of hypoglycaemia in patient groups which are especially vulnerable and susceptible for hypoglycaemia, e.g., subjects with renal impairment, elderly subjects and subjects with on-going insulin therapy. This review summarizes how incretin therapy may meet the challenges of hypoglycaemia and suggests that incretin therapy is a therapy of choice to avoid hypoglycaemia, both in the general diabetes population and in subjects with increased risk or vulnerability for hypoglycaemia.</p>},
  author       = {Farngren, Johan and Ahrén, Bo},
  issn         = {0026-0495},
  keyword      = {DPP-4 inhibitors,GLP-1 receptor agonists,Hypoglycaemia,Incretin therapy,Type 2 diabetes},
  language     = {eng},
  pages        = {25--31},
  publisher    = {Elsevier},
  series       = {Metabolism: Clinical and Experimental},
  title        = {Incretin-based medications (GLP-1 receptor agonists, DPP-4 inhibitors) as a means to avoid hypoglycaemic episodes},
  url          = {http://dx.doi.org/10.1016/j.metabol.2019.06.016},
  volume       = {99},
  year         = {2019},
}