Inkretinbasierte Antidiabetika im Vergleich: GLP-1-Mimetika und DPP-IV-Inhibitoren

Zusammenfassung

Die Behandlung des Typ-2-Diabetes ist bis heute eine Herausforderung. Trotz leitliniengerechter Behandlung erreichen nur etwa ein Drittel der Patienten eine optimale glykämische Kontrolle; andere wichtige Zielgrößen, wie die Gewichtsreduktion, werden oft nicht erreicht. Grundsätzlich ist keine der herkömmlichen Therapien in der Lage, die grundlegenden pathophysiologischen Defekte des Typ-2-Diabetes, nämlich die fortschreitende β-Zell-Dysfunktion und Insulinresistenz, aufzuhalten. Die neuen inkretinbasierten Therapien (GLP-1-Mimetika und DPP-IV-Hemmer) bieten durch ihre gute glykämische Kontrolle eine neue Alternative. Hervorzuheben ist das günstige Körpergewichtsprofil der GLP-1-Mimetika und ihr möglicher positiver Effekt auf die β-Zellfunktion. Die vorliegende Arbeit gibt eine aktuelle Übersicht zu diesen neuartigen GLP-1-basierten Therapien, mit Schwerpunkt auf Exenatide und Liraglutid aus der Substanzklasse der GLP-1-Mimetika.

Abstract

The effective management of type 2 diabetes mellitus continues to pose a challenge to physicians. Despite the use of treatments according to the guidelines, only one third of patients reach the optimal glycemic control target; other goals such as weight loss, often remain unaffected. None of the traditional treatments are able to delay the underlying pathophysiologic defects of type 2 diabetes, i. e. progressive ß-cell-dysfunction and insulin resistance. A new class of anti-diabetic drugs, the incretin-based therapies (GLP-1 mimetics and DPP-IV-inhibitors), provide an alternative option to currently available hypoglycaemic agents. Particular mention deserves the favourable weight-change profile of the GLP-1 mimetics and their potential β-cell regenerating effect. The present article reviews the profile of these new GLP-1-based therapies, focusing on the two GLP-1-mimetics exenatide and liraglutide.

Schlüsselwörter

Typ-2-Diabetes - Antidiabetika - Inkretine - GLP-1-Mimetika - DPP-IV-Inhibitoren

Key words

type 2 diabetes - antidiabetic drugs - incretins - GLP-1 mimetics - DPP-IV-inhibitors

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