Glucagon-like peptide-1: A basis for new approaches to the management of diabetes

Type 2 diabetes mellitus is a metabolic disease resulting in raised blood s ugar which, if not satisfactorily controlled, can cause severe and often de bilitating complications. Unfortunately, for many patients, the existing th erapies do not give adequate control. Glucagon-like peptide-1 (GLP-1) is an incretin hormone which has a spectrum of activities which oppose the sympt oms of diabetes. Of particular significance is the fact that these actions are glucose-dependent, meaning that the risk of severe hypoglycemia is prac tically eliminated. The recent elucidation of the key role of dipeptidyl pe ptidase IV in determining the metabolic stability of GLP-1 has given the ra tionale for two novel therapeutic strategies, namely, GLP-1 analogs which a re resistant to the enzyme and inhibitors of the enzyme which boost levels of endogenous intact GLP-1. These approaches aim to maximize the therapeuti c advantages offered by GLP-1 and give the hope of providing effective glyc emic control without the risk of overt hypoglycemia. (C) 1999 Prous Science . All rights reserved.