Glucagon-like peptide 1 receptor agonists and dipeptidyl peptidase IV inhibitors: new therapeutic agents for the treatment of type 2 diabetes

Purpose of review Current treatments for type 2 diabetes are effective, but a substantial number of patients continue to have difficulty in achieving and maintaining satisfactory control of blood glucose. The available data suggest that enhancing the action of glucagon-like peptide 1 through the use of glucagon-like peptide 1 receptor agonists, or by preventing the degradation of glucagon-like peptide 1 by inhibition of dipeptidyl peptidase IV, may be useful therapeutic approaches for the treatment of type 2 diabetes. Herein we focus on the status of current approaches, based on enhancement of incretin action, for the treatment of type 2 diabetes. Recent findings Degradation-resistant glucagon-like peptide 1 receptor agonists acutely lower blood glucose in human beings by improvement in b cell function, inhibition of gastric emptying, and reduction of glucagon secretion. Treatment with these agents added to existing diabetes therapies, as exemplified by studies of the injectable glucagon-like peptide 1 receptor agonist exenatide, demonstrates significant reduction in HbA1c, together with prevention of weight gain and, in many individuals, significant weight loss over a 30-week study period. Dipeptidyl peptidase IV inhibitors are orally available effective antidiabetic agents that seem to be well tolerated but may not produce weight loss. Less information is currently available about the consequences of long-term treatment with Dipeptidyl peptidase IV inhibitors. Summary Both glucagon-like peptide 1receptor agonists and dipeptidyl peptidase IV inhibitors represent promising new approaches for the treatment of type 2 diabetes. The long-term safety and efficacy of these agents remain to be determined, but the available evidence suggests that these new drug classes will provide novel therapeutic alternatives for the management of diabetes.