Role and development of GLP-1 receptor agonists in the management of diabetes

Abstract

Glucagon-like peptide-1 (GLP-1) is a hormone secreted from enteroendocrine L cells of the intestine in response to food. Exogenous GLP-1 administration at pharmacological doses results in many effects that are beneficial for treating type 2 diabetes, these include: (1) an increase in insulin secretion from β cells; (2) a suppression of glucagon secretion from α cells in the presence of hyperglycemia but not hypoglycemia; (3) a delay in gastric emptying and gut motility which in turns delays absorption of ingested nutrients and dampens post-prandial glucose excursion; and (4) an increase in the duration of postprandial satiety therefore suppressing appetite and decreasing food intake which eventually leads to weight loss. However, GLP-1 is subject to rapid enzymatic degradation, and therefore, not suitable for long-term treatment. A synthetic enzyme-resistant GLP-1 receptor agonist that reproduces the biological effects of GLP-1 is in use and more are under development. This review aims at providing a summary of the properties of GLP-1 and the development of GLP-1-based therapies for treatment of diabetes.

Keywords:

• incretin
• GLP-1
• GLP-1R agonist
• diabetes

Acknowledgments

The writing of this manuscript was supported entirely by the Intramural Research Program of the NIH, National Institute on Aging. The views expressed in this manuscript are those of the authors and do not reflect those of the NIH. The authors report no conflicts of interest in this work.