Incretin-based antidiabetics: GLP-1 mimetics and DPP-IV inhibitors

The effective management of type2 diabetes mellitus continues to pose a challenge to physicians. Despite the use of treatments according to the guidelines, only one third of patients reach the optimal glycemic control target; other goals such as weight loss, often remain unaffected. None of the traditional treatments are able to delay the underlying pathophysiologic defects of type2 diabetes, i.e. progressive beta-cell-dysfunction and insulin resistance. A new class of antidiabetic drugs, the incretin-based therapies (GLP-1 mimetics and DPP-IV-inhibitors), provide an alternative option to currently available hypoglycaemic agents. Particular mention deserves the favourable weight-change profile of the GLP-1 mimetics and their potential P-cell regenerating effect. The present article reviews the profile of these new GLP-1-based therapies, focusing on the two GLP-1-mimetics exenatide and liraglutide.