Incretins and the specific mechanism of action of liraglutide, the first applicable human glucagon-like peptide 1 analog in the treatment of type 2 diabetes

Correspondence: edoardo Mannucci Diabetologia Ponte Nuovo, via delle Oblate, 4-50141 Firenze, italy Tel +39 055 794 9742 Fax +39 055 794 9742 email [email protected] Abstract: Liraglutide is a once-daily glucagon-like peptide 1 (GLP-1) receptor agonist, approved for use as a treatment of type 2 diabetes. Like other drugs of the same class, liraglutide stimulates insulin secretion in a glucose-dependent fashion, has the potential of preventing β-cell mass decline, and inhibits food intake. In addition, experimental studies suggest that the GLP-1 receptor agonists could protect myocardium from ischemic injury, enhancing cardiac function. In clinical trials, liraglutide (in monotherapy or as add-on to 1 or 2 oral drugs) is as effective as, or more effective than, other agents (sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, insulin, and exenatide) in reducing hemoglobin A 1c ; induces weight loss; and has a blood pressure-lowering effect. The possible beneficial cardiovascular effects need to be confirmed by specifically designed long-term studies.