Author: Doggrell, Sheila A.

Source: Reviews on Recent Clinical Trials, Volume 2, Number 1, January 2007 , pp. 77-84(8)

Publisher: Bentham Science Publishers

Abstract:

The obesity epidemic in the developed and developing world is being followed by an epidemic of type 2 diabetes. In type 2 diabetes, subjects cannot manage glucose properly because they do not produce enough insulin, and the peripheral tissues have become resistant to insulin. Glucagon-like peptide 1 (GLP-1) is an intestinal peptide hormone that is secreted in response to food to regulate the postprandial blood glucose concentration. One of the actions of GLP-1 is to stimulate insulin secretion. In subjects with type 2 diabetes, intravenous or subcutaneous GLP-1 stimulated insulin production and decreased blood glucose levels. However, as GLP-1 is rapidly metabolised, it is not suitable for use in most subjects with type 2 diabetes.

Exendin-4 is a 39-amino acid peptide that acts as an agonist at the GLP-1 receptor. After subcutaneous administration, synthetic exendin-4 (exenatide) decreased postprandial concentrations of glucose and insulin, and fasting glucose levels in subjects with type 2 diabetes, and the effects lasted several hours. Subsequently, exenatide was been trialled in subjects taking metformin only, a sulfonylurea only, or metformin and a sulfonylurea, and shown to improve glycemic control with few adverse events, initially over 30 weeks, and then extended to 82 weeks. Exenatide may also be as effective as insulin glargine in subjects with type 2 diabetes not adequately controlled with the oral agents. In conclusion, exenatide represents a new and beneficial addition to the medicines used to treat type 2 diabetes.

Keywords: Clinical trials; Exenatide; Glucagon-like peptide 1; Insulin glargine; Metformin; Sulfonylureas; Type 2 diabetes

Document Type: Research article

DOI: http://dx.doi.org/10.2174/157488707779318053

Affiliations: 1: School of Science, Faculty of Education, Health and Science, Charles Darwin University, Darwin,Northern Territory 0909, Australia.

Publication date: 2007-01-01

More about this publication?

• Reviews on Recent Clinical Trials publishes frontier reviews on recent clinical trials of major importance. The journal's aim is to publish the highest quality review articles in the field. Topics covered include: important Phase I - IV clinical trial studies, clinical investigations at all stages of development and therapeutics.
  
  The journal is essential reading for all researchers and clinicians involved in drug therapy and clinical trials.

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