Agonism of receptors in the gut–pancreas axis in type 2 diabetes: are two better than one?

Abstract

Pharmacotherapy for type 2 diabetes has become complex with the advent of a large number of treatment options. Major goals of therapy include achieving glycaemic targets (glycated haemoglobin [HbA1c] ≤7%) to minimise the development and progression of microvascular and, to a lesser extent, macrovascular complications, while avoiding hypoglycaemia. 1 Inzucchi SE Bergenstal RM Buse JB et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015; 38: 140-149 Crossref PubMed Scopus (2102) Google Scholar Obesity is a key risk factor of type 2 diabetes—hence, the terminology diabesity. 2 Zimmet P Alberti KG Shaw J Global and societal implications of the diabetes epidemic. Nature. 2001; 414: 782-787 Crossref PubMed Scopus (4542) Google Scholar Weight loss, even when modest, might improve not only glycaemic control and cardiovascular risk but also hepatic steatosis—the non-alcoholic fatty liver disease that is now the most common cause of chronic liver disease globally. 3 Diehl AM Day C Cause, pathogenesis, and treatment of nonalcoholic steatohepatitis. N Engl J Med. 2017; 377: 2063-2072 Crossref PubMed Scopus (619) Google Scholar MEDI0382, a GLP-1 and glucagon receptor dual agonist, in obese or overweight patients with type 2 diabetes: a randomised, controlled, double-blind, ascending dose and phase 2a studyMEDI0382 has the potential to deliver clinically meaningful reductions in blood glucose and bodyweight in obese or overweight individuals with type 2 diabetes. Full-Text PDF