Abstract
Diabetes is leading cause for cardiovascular complication, drugs having cardioprotective and antihyperglycemic actions are constantly in search. Oral glucose elicits a three to four times higher peak insulin response compared with an equivalent dose of glucose, if infused intravenously. This is due to the reasons behind, the oral glucose causes a secretion of gut hormones, mainly the glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) which enhance the glucose-induced insulin release. In patients with type 2 diabetes mellitus (type 2 DM), glucose-induced insulin release is unsatisfactory or absent. Because of this type 2 DM patients are unable to adjust their insulin secretion as per the need exist. GLP-1 secretion (but not GIP secretion) is diminished in patients with type 2 diabetes. However, when the GLP-1 and GIP agonist are administered in patients with type 2 diabetes, they elicit insulin secretion resulting in lowering of blood glucose level. In addition to its insulin stimulatory effect, GLP-1 agonist also induces cardioprotective effects. It increases nuclear respiratory factor-2 (Nrf2) and heamoxigenase-1(Ho-1) in cell which have antioxidant and cardioprotective property. GLP-1 maintains islets integrity and reduces apoptotic cell death of human islet cells in culture. Improved understanding of the mechanism of action and clinical effects of incretin-based therapies would be useful in advancement of its appropriate use in clinical practices.
Highlights
Oral glucose load enhances the release of insulin than the similar quantity if administered intravenously and a difference of 40%-60% in the area- under-the curve of the insulin time concentration graph is registered
This is due to the reasons behind, the oral glucose causes a secretion of gut hormones, mainly the glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) which enhance the glucose-induced insulin release
Liraglutide-based therapies are relatively new options for the treatment of patients with type 2 diabetes. These agents have low risk associated with hypoglycemia and weight gain in contrast to those drugs which are generally used in the treatment of type-2 diabetes mellitus and shows cardioprotective effect
Summary
Quick response code: Diabetes is leading cause for cardiovascular complication, drugs having cardioprotective and antihyperglycemic actions are constantly in search. Oral glucose elicits a three to four times higher peak insulin response compared with an equivalent dose of glucose, if infused intravenously. This is due to the reasons behind, the oral glucose causes a secretion of gut hormones, mainly the glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) which enhance the glucose-induced insulin release. In patients with type 2 diabetes mellitus (type 2 DM), glucose-induced insulin release is unsatisfactory or absent. When the GLP-1 and GIP agonist are administered in patients with type 2 diabetes, they elicit insulin secretion resulting in lowering of blood glucose level. In addition to its insulin stimulatory effect, GLP-1 agonist induces cardioprotective effects.
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