Glucagon-like peptide

General information

Glucagon-like peptide-1 is an intestinal hormone that increases insulin secretion and biosynthesis, has a trophic effect on beta cells, suppresses glucagon secretion, delays gastric emptying, increases satiety, and reduces food intake [ ]. Its effects are glucose-dependent and it should not cause hypoglycemia, but in healthy subjects hypoglycemia can occur after high doses or after fasting. Although it is a candidate for the treatment of type 2 diabetes, it has to be injected and is extremely rapidly degraded by dipeptidyl peptidase IV. Analogues that are resistant to degradation and inhibitors of the degrading enzyme are being investigated.

Glucagon-like peptide-1 is quickly degraded and therefore long-acting glucagon-like peptide receptor agonists and oral inhibitors of dipeptidyl peptidase IV (DPP-IV), which inhibit the degradation of glucagon-like peptide-1, and glucose-dependent insulinotropic peptide (GIP) have been developed [ ]. The agonists can cause nausea and vomiting, but have more potency for glucose lowering than DPP-IV inhibitors. Exenatide (synthetic exendin-4, from the saliva from a lizard), which has a 53% overlap with glucagon-like peptide-1 and which also binds to the glucagon-like peptide-1 receptor, is the subject of a separate monograph, as are the dipeptidyl peptidase IV inhibitors.

Drug studies