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Gábor Winkler Szent János Municipal Hospital 2nd Department of Internal Medicine Diós árok 1–3 H-1125 Budapest Hungary

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The incretins are peptide hormones produced by special cell types of the intestine. After having been secreted upon ingestion of food, they participate in the regulation of glucose homeostasis indirectly, through a complex mechanism, by decreasing postprandial blood glucose levels. In addition to summarizing the physiological aspects of the two most important incretins, glucagon-like peptide (GLP)-1 and glucose-dependent insulinotrope polypeptide (GIP), the article gives a detailed overview of the pharmacodynamic effects of GLP-1 and their potential application in the therapy of Type 2 diabetes mellitus. Due to its very short half-life the human GLP-1 is not suitable for everyday therapeutic use. However, its effect can be prolonged by inhibiting its degradation, i.e. by suppressing the activity of the – serine peptidase type enzyme – dipeptidyl peptidase (DPP) IV. Compounds with such effect have been synthesized; and drugs resistant to DPP IV, not being identical with the structure of the human GLP-1 but having an agonist effect on its receptor could also be manufactured. Members of the two groups are called incretin (GLP-1) enhancers and incretinomimetics, respectively. After encouraging preclinical and human experiences, two of the enhancers, sita- and vildagliptin as well as one representative of the incretinomimetics, exenatide (synthetic exendin-4) have also been registered and introduced into clinical practice. Their potential place in the treatment of Type 2 diabetes is yet to be established. Though there are arguments suggesting their early use as monotherapy, their application as part of a combination therapy with other antidiabetics seems to be a realistic indication.

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  • Winkler, G, Cseh, K.: Az inkretinmimetikum exenatid – új kezelési lehetőség a 2-es típusú diabetesben. (The incretin mimeticum exenatide, a new way in the treatment of type 2 diabetes mellitus) (In Hungarian). Diabetol. Hung., 2005, 13 (Suppl. 3) , 20–29.

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Hungarian Medical Journal
Language English
Size  
Year of
Foundation
2007
Publication
Programme
ceased
Volumes
per Year
 
Issues
per Year
 
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 1788-6139 (Print)
ISSN 1789-0403 (Online)