Incretins beyond type 2 diabetes

Diabetologia. 2023 Oct;66(10):1809-1819. doi: 10.1007/s00125-023-05980-x. Epub 2023 Aug 8.

Abstract

Incretin-based therapies, in particular glucagon-like peptide-1 (GLP-1) receptor agonists, have been evaluated in other forms of diabetes, but randomised controlled trials are mainly limited to people living with type 1 diabetes. In this review we present the evidence issuing from these trials and discuss their clinical implications as well as the difficulties in interpreting the data. In type 1 diabetes, the addition of GLP-1 receptor agonists to intensive insulin therapy lowers weight and required insulin doses compared with placebo, but the effects on glucose control (HbA1c, risk of hypoglycaemia) are dependent on the different study protocols. Side effects are limited to the gastrointestinal complaints of nausea, vomiting and diarrhoea. We briefly discuss the potential for using GLP-1 receptor agonists as (adjunct) therapies in other forms of diabetes, where the evidence to date is scarce.

Keywords: GLP-1 receptor agonists; Glucose control; Incretins; Monogenic diabetes; Review; Type 1 diabetes; Weight.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 1* / drug therapy
  • Diabetes Mellitus, Type 2* / chemically induced
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucagon-Like Peptide-1 Receptor / agonists
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Incretins / therapeutic use
  • Insulin / therapeutic use

Substances

  • Incretins
  • Hypoglycemic Agents
  • Glucagon-Like Peptide-1 Receptor
  • Insulin