Fast Five Quiz: Type 2 Diabetes Incretin-Based Therapy

Romesh Khardori, MD, PhD; Anne L. Peters, MD

May 16, 2022

In type 2 diabetes, the impact of weight should be considered when choosing the most appropriate glucose-lowering therapies. GLP-1 RAs are more effective than DPP-4 inhibitors when weight loss or greater reductions in A1c are treatment priorities. GLP-1 RAs confer weight loss and blood pressure effects that may contribute to long-term cardiovascular efficacy. In addition, GLP-1 RAs also inhibit glucagon secretion, decrease gastric emptying, and reduce appetite through central nervous system pathways. Compared with insulin regimens that may cause weight gain, GLP-1 RAs often result in substantial weight loss, and exogenous administration of GLP-1 has become a widely utilized strategy to lower glucose and weight. Both long-acting and short-acting GLP RAs confer a similar weight loss benefit.

SGLT2 inhibitors have natriuretic and osmotic diuretic effects, whereas GLP-1 RAs have natriuretic and vasodilating effects.

Combination therapy with GLP-1 RAs and DPP-4 inhibitors is not recommended, as both elevate GLP-1 and GIP plasma concentrations with nonsignificant effects on glycemic control.

Learn more about type 2 diabetes guidelines.

1 2 3 4 5 6

Next Section

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Romesh Khardori, Anne L. Peters. Fast Five Quiz: Type 2 Diabetes Incretin-Based Therapy - Medscape - May 16, 2022.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.