Exenatide : The glucagonlike peptide1 (GLP1) is an important incretin that is released from the gut in response to oral glucose. It is difficult to use clinically because of rapid degradation by the enzyme dipeptidyl peptidase4 (DPP4).
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The glucagonlike
peptide1 (GLP1) is an important incretin
that is released from the gut in response to oral glucose. It is difficult to
use clinically because of rapid degradation by the enzyme dipeptidyl peptidase4
(DPP4). Exenatide is a synthetic GLP1
analogue, resistant to DPP4, but with similar actions, viz. enhancement of postprandial insulin release, suppression of
glucagon release and appetite as well as slowing of gastric emptying. It has
been marketed in the USA to be used as an additional drug with metformin and/or
sulfonylureas in type 2 diabetics who have inadequate response to the oral
hypoglycaemics. Exenatide is injected s.c. twice daily 1 hour before meals;
acts for 6–10 hours. Nausea is an important side effect.
This
orally active inhibitor of DPP4 prevents degradation of
endogenous GLP1 and other incretins, potentiating their action, resulting in
limitation of postprandial hyperglycaemia. It is undergoing clinical evaluation
as an addon drug to sufonylurea/ metformin/ thiazolidinediones in type 2 DM.
This synthetic amylin
(a polypeptide produced by pancreatic
β cells which reduces
glucagon secretion from α cells and delays gastric emptying) analogue
attenuates postprandial hyperglycaemia when injected s.c. just before a meal,
and exerts a centrally mediated anorectic action. The duration of action is 2–3
hours. It has been marketed as an adjuvant to insulin/ sulfonylureas/metformin
for control of mealtime glycaemia in both type1 and type2 diabetes.
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