The GLP-1 receptor and its peptide ligands. Glucagon-like peptide 1 (7-36) amide (GLP-1) is a 30 amino acid peptide produced in intestinal L cells and released into the bloodstream in response to food intake. It is a potent ‘incretin’, in that it increases glucose-dependent secretion of insulin by pancreatic β-cells. GLP-1 has also been shown to stimulate pro-insulin gene transcription in the p...

Diabetes has historically been thought of as a medical specialty which primarily deals with treatment rather than diagnosis. Molecular genetic testing can now be used to make a diagnosis of the 1-2% of all diabetic patients with monogenic diabetes. Making a diagnosis of monogenic diabetes is important as it can have a dramatic effect on the treatment a patient should receive: glucokinase MODY p...

AIMS Sulphonylurea use has been linked with increased cardiovascular disease risk; however, previous studies have been inconsistent. Type 2 diabetes independently increases risk for cardiovascular disease, so understanding the link between longer-term use of anti-diabetic medications and cardiovascular disease has important clinical implications. METHODS Literature search in MEDLINE and CENTR...

BACKGROUND We compared all-cause mortality, major macrovascular events (MACE) and diabetes-related hospitalizations in T2DM-incident patients newly treated with metformin (MET) versus sulphonylureas (SU) monotherapy and in T2DM-prevalent patients newly treated with MET+SU versus MET+DPP4-inhibitor combination therapy. METHODS We analysed anonymized data obtained from a German health fund. Pat...

BACKGROUND Previous reports suggest that currently available drugs used in the treatment of type 2 diabetes do not sustain glycaemic control. OBJECTIVE To assess metabolic control in type 2 diabetic patients predominantly treated with sulphonylurea drugs at primary care clinics in a developing country. DESIGN Descriptive. SETTING Two primary care clinics in Trinidad, West Indies. SUBJEC...

At this moment, approximately ten different classes of drugs are or soon will become available for the treatment of type 2 diabetes mellitus (table 1). Of the glucoselowering agents, pramlintide has not been approved by the European Medicines Agency (EMEA) and two, a GLP (glucagon-like peptide)-1 and a DPP (dipeptidyl peptidase)IV-inhibitor, have recently been approved but have not yet become a...