Progressive incretinology: β-cell in focus

• Alexander S. Ametov
• Dinara G. Gusenbekova

Abstract

Type 2 diabetes mellitus (T2DM) is a sever, progressive disease leading to microvascular and macrovascular complications. Insulin resistance and impaired insulin secretion remain the core defects in T2DM, but some other pathophysiological abnormalities contribute to the dysregulation of glucose metabolism. The multiple pathogenetic disturbances present in T2DM dictate that multiple antidiabetic agents, used in combination, will be required to maintain normoglycaemia. A decline in pancreatic β-cell function has been defined as a key contributing factor to progression of T2DM. In fact, a significant proportion of β-cell secretory capacity is thought to be lost well before the diagnosis of T2DM is made. The dipeptidyl peptidase‑4 inhibitor sitagliptin (Januvia^®, Sitadiab^® etc) is approved as monotherapy and in combination with other antihyperglycaemic drugs for the treatment of adult patients with T2DM. Extensive clinical experience has firmly established the glycaemic efficacy of oral sitagliptin (±other antihyperglycaemic drugs) in a broad spectrum of patients with T2DM, including obese, elderly and renally impaired patients and those with established cardiovascular disease. The medical approval of high-quality generics of sitagliptin – Sitadiab^® (Gedeon Richter, Hungary) – make its use in clinical practice more affordable.

Keywords:type 2 diabetes mellitus; sitagliptin; β-cells; dipeptidyl peptidase 4 inhibitors

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