New Advances in Therapy for Type 2 Diabetes

New Advances in

Therapy for Type 2 Diabetes

Incretin -Based Therapy

Alireza Esteghamati, MD

Professor of Endocrinology and Metabolism

TUMS

THE INCRETIN EFFECT AND GLUCAGON-LIKE PEPTIDE 1 THERAPY

GLP-1 a 30-amino-acid polypeptide derived from proglucagon gene

Rapidly secreted into bloodstream from enteroendocrine L-cells in distal small intestine & colon in response to food ingestion.

Within the L-cells of the small intestine, proglucagon peptide is processed by prohormone convertase  to

GLP-1

GLP-2 (a key regulator of small intestinal growth)

glicentin

GLP-1 a pluripotent natural incretin hormone

Exerts multiple physiological actions throughout the body.

The name “incretin” is derived from the Latin word increscere (meaning “to increase”) and refers to the strong insulinotropic effect on pancreatic beta-cells of the incretin hormones GLP-1 and GIP.

The incretin effect :

When glucose is administered orally, it results in a much more profound increase in plasma insulin  compared with insulin increase after iv glucose, despite equivalent blood glucose profiles