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October 2016

Glucagon-like Peptide 1 Drugs as Second-line Therapy for Type 2 Diabetes

Author Affiliations
  • 1Larry L. Hillblom Islet Research Center, David Geffen School of Medicine, University of California–Los Angeles
JAMA Intern Med. 2016;176(10):1440-1442. doi:10.1001/jamainternmed.2016.1523

Two relatively new classes of therapeutics, dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide 1 (GLP-1) agonists (Table 1 and Table 2), have been widely adopted in practice for diabetes management based on clinical trial evidence demonstrating effective glycosylated hemoglobin control, benefits for weight management, and low risk of hypoglycemia. It has been suggested that these agents may also reduce risk for cardiovascular outcomes among patients with diabetes. This benefit has recently been reported in a placebo control randomized clinical trial (RCT) for the GLP-1 agonist Liraglutide (Victoza).1 GLP-1 agonists amplify glucose-mediated insulin secretion, whereas DPP-4 inhibitors enhance and prolong the action of endogenously secreted GLP-1.

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