Chapter-013 Incretin-Based Therapies

BOOK TITLE: ESI Manual of Clinical Endocrinology

1. Ayyar Vageesh S
2. Mathew Vivek
Publishing Year
Author Affiliations
1. St. John’s Medical College and Hospital, Bengaluru, Karnataka, India, St John’s Medical College and Hospital, Bengaluru, Karnataka, India
2. St. John’s Medical College, Bangaluru, Karnataka, India, St. john’s Medical College and Hospital, Bengaluru, Karnataka, India, Christian Medical College, Vellore, Tamil Nadu, India, St John’s Medical College and Hospital, Bengaluru, Karnataka, India
Chapter keywords
Incretin-based therapies, gastric Inhibitory polypeptide, GLP-1, dipeptidyl peptidase-4, Incretin mimetics, exenatide, liraglutide


Incretin-based therapies (IBT) consist of agents that retard the progression of the disease and also extend pleotropic effects. Gastric inhibitory polypeptide (GIP) was identified as the first incretin hormone. Incretin effect is the key factor which maintains glucose homeostasis. GLP-1 and GIP are the two important hormones involved in incretin effects. Incretin hormones including GLP-1 and GIP are secreted immediately after the ingestion of the nutrients such as carbohydrates or lipids. The physiologic actions of the incretin hormones start when they bind to their specific receptors in the pancreatic islets cells. Dipeptidyl peptidase-4 (DPP-4) inactivates GLP-1 and GIP and the metabolites of GLP-1 and GIP are eliminated through the kidneys because of inactivation. Incretin mimetics, exenatide and liraglutide are incretin-based therapies explained in this chapter. Exenatide long-acting release, albiglutide, taspoglutide and lixisenatide are most recent development in GLP-1RAs. Sitagliptin, vildagliptin, saxagliptin and linagliptin are used to increase a very short half-life of GLP-1. This chapter also gives an explanation about extraglycemic effects and the safety of IBT.

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