The spectrum of antidiabetic actions of GLP-1 in patients with diabetes

This article focusses on the antidiabetic therapeutic potential of the incretin hormone glucagon-like peptide-1 (GLP-1) in the treatment of patients with type 2 diabetes mellitus (T2DM). T2DM is characterised by insulin resistance, impaired glucose-induced insulin secretion and inappropriately regulated glucagon secretion, which in combination eventually result in hyperglycaemia and, in the longer term, microvascular and macrovascular diabetic complications. Traditional treatment modalities – even multidrug approaches – for T2DM are often unsatisfactory in making patients reach glycaemic goals as the disease progresses caused by a steady, relentless decline in pancreatic beta-cell function. Furthermore, current treatment modalities are often limited by inconvenient dosing regimens and safety and tolerability issues, the latter including hypoglycaemia, body weight gain, oedema and gastrointestinal side effects. Therefore, the actions of GLP-1, which include the potentation of meal-induced insulin secretion and trophic effects on the beta-cell, have attracted a lot of interest. GLP-1 also inhibits glucagon secretion and suppresses food intake and appetite.