TYPE 2 DIABETES MELLITUS: POTENTIALS FOR ACHIEVEMENT OF OPTIMAL CONTROL WITHOUT SIDE EFFECTS


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Abstract

Modern pharmacotherapy of type 2 diabetes mellitus (DM2) should be directed not only to achievement and maintenance a target level of glycemia, but also to adequate control of blood pressure and correction of hyperlipidemia for the purpose of reduction of risk of development and progression of DM2-assosiated complications and mortality (including cardiovascular mortality). Incretin hormones, especially glucagon-like peptide-1 (GLP-1), play an important role in the homeostasis of glucose metabolism. In humans, GLP-1 causes glucose-related stimulation of insulin secretion by β-cells in the pancreas, as well as the suppression of glucagon production, thereby provides maintenance of normoglycemia. In addition, GLP-1 stimulates insulin biosynthesis, improves peripheral insulin sensitivity, promotes the active absorption of glucose by the liver, muscle and adipose tissue, delays gastric emptying, reduces food intake, which leads to a decrease in body weight, and provides cardio-vascular and neurotrophic action. The article presents the results of randomized clinical trials aimed to evaluation of efficacy of liraglutide (Victoza) - the first long-acting analogue of human GLP-1, whose appearance opens new prospects in the treatment of DM2. Currently, Victoza is the strongest non-insulin hypoglycemic agent.

References

  1. U.K. Prospective Study Group: Intensive blood-glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS). Lancet 1998;352:837-53.
  2. Briscoe VJ, Davis SN. Hypoglycemia in type 1 and type 2 diabetes: Physiology, pathophysiology and management. Clin Diabetes 2006;24:115-21.
  3. Amiel SA, Dixon T, Mann R, et al. Hypoglycaemia in type 2 diabetes. Diabet Med 2008;25:245-54.
  4. Gangji AS, Cukierman T, Gerstein HC, et al. A systematic review and meta-analysis of hypoglycemia and cardiovascular events: a comparison of glyburide with other secretagogues and with insulin. Diabetes Care 2007;30:389-94.
  5. Cryer PE, Davis SN, Shamoon H. Hypoglycaemia in diabetes. Diabetes Care 2003;26:1902-12.
  6. Wright RJ, Frier BM. Vascular disease and diabetes: is hypoglycaemia an aggravating factor? Diabetes Metab Res Rev 2008;24:353-63.
  7. Kushner RF, Sujak M. Prevention of weight gain in adult patients with type 2 diabetes treated with pioglitazone. Obesity (Silver Spring) 2009;17:1017-22.
  8. Carver C. Insulin treatment and the problem of weight gain in type 2 diabetes. Diabetes Educ 2006;32:910-7.
  9. UK Prospective Diabetes Study (UKPDS) Group. UKPDS Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.
  10. Hauber AB, Mohamed AF, Johnson FR, et al. Treatment preferences and medication adherence of people with type 2 diabetes using oral glucose-lowering agents. Diabet Med 2009;26:416-24.
  11. Williamson DF, Thompson TJ, Thun M, et al. Intentional weight loss and mortality among overweight individuals with diabetes. Diabetes Care 2000;23:1499-504.
  12. Farmer A, Kinmonth AL, Sutton S. Measuring beliefs about taking hypoglycaemic medication among people with type 2 diabetes. Diabet Med 2006;23:265-70.
  13. Zarowitz BJ, Conner C. The Intersection of Safety and Adherence: New Incretin-Based Therapies in Patients with Type 2 Diabetes Mellitus. Pharmacotherapy 2009;29(12 Pt 2):55-67.
  14. Shah BR, Hux JE, Laupacis A, Zinman B, et al. Clinical inertia in response to inadequate glycemic control: do specialists differ from primary care physicians? Diabetes Care 2005;28:600-6.
  15. Grant R, Adams AS, Trinacty CM, et al. Relationship between patient medication adherence and subsequent clinical inertia in type 2 diabetes glycemic management. Diabetes Care 2007;30:807-12.
  16. Currie CJ, Morgan CL, Poole CD, et al. Multivariate models of health-related utility and the fear of hypoglycaemia in people with diabetes. Curr Med Res Opin 2006;22:1523-34.
  17. Patel A, MacMahon S, Chalmers J, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007;370:829-40.
  18. Nauck MA, Kleine N, Orskov C, et al. Normalization of fasting hyperglycaemia by exogenous glucagon-like peptide 1 (7-36 amide) in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 1993;36:741-44. .
  19. Juhl C, Hollingdal M, Sturis J, et al. Bedtime administration of NN2211, a long-acting GLP-1 derivative, substantially reduces fasting and postprandial glycemia in type 2 diabetes. Diabetes 2002;51:424-29
  20. Chang AM, Jakobsen G, Sturis J, et al. The GLP-1 derivative NN2211 restores beta cell sensitivity to glucose in type 2 diabetic patients after a single dose. Diabetes 2003;52:1786-91.
  21. Holst JJ. The physiology of glucagon-like peptide 1. Physiol Rew 2007;87:1409-39.
  22. Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology 2007;132:2131-57.
  23. Kieffer TJ, McIntosh CH, Pederson RA. Degradation of glucose-dependent insulinotropic polypeptide and truncated glucagon-like peptide 1 in vitro and in vivo by dipeptidyl peptidase IV. Endocrinology 1995;136:3585-96.
  24. Steensgaard DB, Thomsen JK, Olsen HB, et al. Structure-activity and protraction relationship of long-acting glucagon-like peptide-1 derivatives: importance of fatty acid length, polarity and bulkiness. J Med Chem 2007;50:6126-32.
  25. Elbrond B, Jakobsen G, Larsen S, et al. Pharmacokinetics, pharmacodynamics, safety, and tolerability of a single-dose of NN2211, a long-acting glucagon-like peptide 1 derivative, in healthy male subjects. Diabetes Care 2002;25:1398-404.
  26. Fakhoury WKH, LeReun C, Wright D. A Meta-Analysis of Placebo-Controlled Clinical Trials Assessing the Efficacy and Safety of Incretin-Based Medications in Patients with Type 2 Diabetes. Pharmacology 2010;86:44-57.
  27. Marre M, Shaw J, Brandle M, et al. Liraglutide, a once-daily human GLP-1 analogue, added to a sulphonylurea over 26 weeks produces greater improvements in glycemia and weight control compared with adding rosiglitazone or placebo in subjects with type 2 diabetes (LEAD-1 SU). Diabet Med 2009;26:268-78.
  28. Nauck MA, Frid A, Hermansen K, et al. LEAD-2 Study Group Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin in type 2 diabetes. Diabetes Care 2009;32:84-90.
  29. Garber A, Henry R, Ratner R, et al. Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono): a randomised, 52-week, phase III, double-blind, parallel-treatment trial. Lancet 2009;373:473-81.
  30. Zinman B, Gerich J, Buse J, et al. Efficacy and safety of the human GLP-1 analog liraglutide in combination with metformin and TZD in patients with type 2 diabetes mellitus (LEAD-4 Met+TZD). Diabetes Care 2009;32:1224-30.
  31. Russell-Jones D, Vaag A, Schmitz O, et al. Liraglutide vs insulin glargine and placebo in combination with metformin and sulphonylurea therapy in type 2 diabetes mellitus: a randomised controlled trial (LEAD-5 met+SU). Diabetologia 2009;52:2046-55.
  32. Buse J, Rosenstock J, Sesti G, et al. Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6). Lancet 2009;374:39-47.
  33. Nauck ,et al. IDF 20th World Diabetes Congress 2009;1400.
  34. Zinman B, Buse J, Falahati A, et al. Liraglutide more effectively achieves a composite endpoint for A1c, SBP and weight change than other diabetes therapies. Diabetes 2009;58(1):537.
  35. Rodbard HW, Jellinger PS, Davidson JA, et al. Statement by an American Association of Clinical Endocrinologists ⁄ American College of Endocrinology consensus panel on type 2 diabetes mellitus: an algorithm for glycemic control. Endocr Pract 2009;15:540-59.
  36. McGill JB. Insights from the liraglutide clinical development program - the liraglutide effect and action in diabetes (LEAD) studies. Postgrad Med 2009;121:16-25.
  37. Russell-Jones D, Vaag A, Schmitz O, et al. Significantly better glycemic control and weight reduction with liraglutide, a once-daily human GLP-1 analog, compared with insulin glargine: all as add-on to metformin and a sulfonylurea in type 2 diabetes (Abstract). Diabetes 2008;57 (Suppl. 1):A159.
  38. Jendle J, et al. Diabetes 2008;57(1):A32.
  39. National Institutes of Health. National diabetes statistics, 2007. Available from URL:http://diabetes.niddk.nih.gov/dm/pubs/statistics/index.htm. Accessed 25 September 2009.
  40. Adler AI, Stratton IM, Neil HA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000;321:412-19.
  41. Niswender K. Diabetes and obesity: therapeutic targeting and risk reduction - a complex interplay. Diabetes, Obesity and Metabolism 2010;12:267-87.
  42. Fonseca V, Madsbad S, Falahati A, et al. Once-daily human GLP-1 analog liraglutide reduces systolic blood pressure - a meta-analysis of six clinical trials (LEAD). Diabetes 2009;58(1):545.
  43. Fonseca V, et al. Diabetologia 2009;52(1):S299

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