Cargando…

A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is an independent risk factor for cardiovascular (CV) comorbidities, with CV disease being the most common cause of death in adults with T2DM. Although glucocentric therapies may improve glycaemic control (as determined by glycated haemoglobin levels), evidence sugges...

Descripción completa

Detalles Bibliográficos
Autores principales: Owens, David R., Monnier, Louis, Hanefeld, Markolf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697665/
https://www.ncbi.nlm.nih.gov/pubmed/28474401
http://dx.doi.org/10.1111/dom.12998
_version_ 1783280661460680704
author Owens, David R.
Monnier, Louis
Hanefeld, Markolf
author_facet Owens, David R.
Monnier, Louis
Hanefeld, Markolf
author_sort Owens, David R.
collection PubMed
description Type 2 diabetes mellitus (T2DM) is an independent risk factor for cardiovascular (CV) comorbidities, with CV disease being the most common cause of death in adults with T2DM. Although glucocentric therapies may improve glycaemic control (as determined by glycated haemoglobin levels), evidence suggests that this approach alone has limited beneficial effects on CV outcomes relative to improvements in lipid and blood pressure control. This may be explained in part by the fact that current antidiabetic treatment regimens primarily address overall glycaemia and/or fasting plasma glucose, but not the postprandial plasma glucose (PPG) excursions that have a fundamental causative role in increasing CV risk. This literature review evaluates the relationship between PPG and the risk of CV disease, discusses the treatment of T2DM with glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and examines the associated CV outcomes. The literature analysis suggests that exaggerated PPG excursions are a risk factor for CV disease because of their adverse pathophysiologic effects on the vasculature, resulting in increased all‐cause and CV‐related mortality. Although GLP‐1 RAs are well established in the current T2DM treatment paradigm, a subgroup of these compounds has a particularly pronounced, persistent and short‐lived effect on gastric emptying and, hence, lower PPG substantially. However, current long‐term data on CV outcomes with GLP‐1 RAs are contradictory, with both beneficial and adverse effects having been reported. This review explores the opportunity to direct treatment towards controlling PPG excursions, thereby improving not only overall glycaemic control but also CV outcomes.
format Online
Article
Text
id pubmed-5697665
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Blackwell Publishing Ltd
record_format MEDLINE/PubMed
spelling pubmed-56976652017-11-28 A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus Owens, David R. Monnier, Louis Hanefeld, Markolf Diabetes Obes Metab Review Articles Type 2 diabetes mellitus (T2DM) is an independent risk factor for cardiovascular (CV) comorbidities, with CV disease being the most common cause of death in adults with T2DM. Although glucocentric therapies may improve glycaemic control (as determined by glycated haemoglobin levels), evidence suggests that this approach alone has limited beneficial effects on CV outcomes relative to improvements in lipid and blood pressure control. This may be explained in part by the fact that current antidiabetic treatment regimens primarily address overall glycaemia and/or fasting plasma glucose, but not the postprandial plasma glucose (PPG) excursions that have a fundamental causative role in increasing CV risk. This literature review evaluates the relationship between PPG and the risk of CV disease, discusses the treatment of T2DM with glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and examines the associated CV outcomes. The literature analysis suggests that exaggerated PPG excursions are a risk factor for CV disease because of their adverse pathophysiologic effects on the vasculature, resulting in increased all‐cause and CV‐related mortality. Although GLP‐1 RAs are well established in the current T2DM treatment paradigm, a subgroup of these compounds has a particularly pronounced, persistent and short‐lived effect on gastric emptying and, hence, lower PPG substantially. However, current long‐term data on CV outcomes with GLP‐1 RAs are contradictory, with both beneficial and adverse effects having been reported. This review explores the opportunity to direct treatment towards controlling PPG excursions, thereby improving not only overall glycaemic control but also CV outcomes. Blackwell Publishing Ltd 2017-07-11 2017-12 /pmc/articles/PMC5697665/ /pubmed/28474401 http://dx.doi.org/10.1111/dom.12998 Text en © 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Articles
Owens, David R.
Monnier, Louis
Hanefeld, Markolf
A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus
title A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus
title_full A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus
title_fullStr A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus
title_full_unstemmed A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus
title_short A review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus
title_sort review of glucagon‐like peptide‐1 receptor agonists and their effects on lowering postprandial plasma glucose and cardiovascular outcomes in the treatment of type 2 diabetes mellitus
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697665/
https://www.ncbi.nlm.nih.gov/pubmed/28474401
http://dx.doi.org/10.1111/dom.12998
work_keys_str_mv AT owensdavidr areviewofglucagonlikepeptide1receptoragonistsandtheireffectsonloweringpostprandialplasmaglucoseandcardiovascularoutcomesinthetreatmentoftype2diabetesmellitus
AT monnierlouis areviewofglucagonlikepeptide1receptoragonistsandtheireffectsonloweringpostprandialplasmaglucoseandcardiovascularoutcomesinthetreatmentoftype2diabetesmellitus
AT hanefeldmarkolf areviewofglucagonlikepeptide1receptoragonistsandtheireffectsonloweringpostprandialplasmaglucoseandcardiovascularoutcomesinthetreatmentoftype2diabetesmellitus
AT owensdavidr reviewofglucagonlikepeptide1receptoragonistsandtheireffectsonloweringpostprandialplasmaglucoseandcardiovascularoutcomesinthetreatmentoftype2diabetesmellitus
AT monnierlouis reviewofglucagonlikepeptide1receptoragonistsandtheireffectsonloweringpostprandialplasmaglucoseandcardiovascularoutcomesinthetreatmentoftype2diabetesmellitus
AT hanefeldmarkolf reviewofglucagonlikepeptide1receptoragonistsandtheireffectsonloweringpostprandialplasmaglucoseandcardiovascularoutcomesinthetreatmentoftype2diabetesmellitus