Abstract
Abstract: The cardiovascular complications of Type 2 Diabetes Mellitus (T2DM) including myocardial infarction, heart failure, peripheral vascular disease and, stroke and retinopathy, nephropathy and neuropathy are microvascular complications. While the newer therapies like glitazones or even Dipeptidyl- peptidase-IV (DPP-IV) inhibitors increase the risk of therapy, the Glucagon Like Peptide-1 Receptor Agonists (GLP-1RAs), were reported as suitable alternates. The GLP-1RAs reduce Major Adverse Cardiovascular Events (MACE), have anti-atherogenic potential, and possess pleiotropic activity. The GLP-1RAs were found to improve neuroprotection, enhance neuronal growth, reduce the incidence of stroke, and improve central insulin resistance. The GLP-1RAs are beneficial in improving the glycemic profile, preventing macroalbuminuria and reducing the decline in eGFR and enhancing renal protection. The renal benefits of add-on therapy of GLP-1RAs with SGLT-2 inhibitors have composite renal outcomes such as suppression of inflammatory pathways, improvement in natriuresis, diuresis, found to be nephroprotective. Improvement in glycemic control with a reduction in body weight and intraglomerular pressure and prevention of tubular injury makes the GLP-1RAs as suitable add-on therapies in improving cardiorenal outcomes. Obesity, an important contributor to insulin resistance and a reduction in weight, is an essential therapeutic option in addressing diabetic-obesity. It also reduces the damage to blood-retinal-barrier, thus beneficial in halting the development of diabetic retinopathy. In diabetic complications, glycemic control, addressing insulin resistance through weight loss, controlling atherosclerosis through anti-inflammatory effects and cardio-renal-neuro protection, makes GLP-1RAs a suitable therapeutic strategy on long-term treatment of T2DM. This review discusses the role of GLP-1RAs in diabetes, the dosage, mono or combination therapy with other antidiabetics in long-term treatment and its effect in uncontrolled diabetes.
Keywords: Glucagon like peptide-1, dipeptidyl-peptidase, diabetes, neuropathy, retinopathy, microvascular complications.
Graphical Abstract
Mini-Reviews in Medicinal Chemistry
Title:Role of GLP-1 Analogs in the Management of Diabetes and its Secondary Complication
Volume: 21 Issue: 20
Author(s): Ponnurengam Malliappan Sivakumar, B. Premkumar *, Veluchamy Prabhawathi and Pranav Kumar Prabhakar*
Affiliation:
- Department of Pharmacology, K. K College of Pharmacy, Gerugambakkam, Chennai, Tamil Nadu, India
- Department of Medical Laboratory Sciences, Lovely Professional University, Punjab, India-144411
Keywords: Glucagon like peptide-1, dipeptidyl-peptidase, diabetes, neuropathy, retinopathy, microvascular complications.
Abstract: Abstract: The cardiovascular complications of Type 2 Diabetes Mellitus (T2DM) including myocardial infarction, heart failure, peripheral vascular disease and, stroke and retinopathy, nephropathy and neuropathy are microvascular complications. While the newer therapies like glitazones or even Dipeptidyl- peptidase-IV (DPP-IV) inhibitors increase the risk of therapy, the Glucagon Like Peptide-1 Receptor Agonists (GLP-1RAs), were reported as suitable alternates. The GLP-1RAs reduce Major Adverse Cardiovascular Events (MACE), have anti-atherogenic potential, and possess pleiotropic activity. The GLP-1RAs were found to improve neuroprotection, enhance neuronal growth, reduce the incidence of stroke, and improve central insulin resistance. The GLP-1RAs are beneficial in improving the glycemic profile, preventing macroalbuminuria and reducing the decline in eGFR and enhancing renal protection. The renal benefits of add-on therapy of GLP-1RAs with SGLT-2 inhibitors have composite renal outcomes such as suppression of inflammatory pathways, improvement in natriuresis, diuresis, found to be nephroprotective. Improvement in glycemic control with a reduction in body weight and intraglomerular pressure and prevention of tubular injury makes the GLP-1RAs as suitable add-on therapies in improving cardiorenal outcomes. Obesity, an important contributor to insulin resistance and a reduction in weight, is an essential therapeutic option in addressing diabetic-obesity. It also reduces the damage to blood-retinal-barrier, thus beneficial in halting the development of diabetic retinopathy. In diabetic complications, glycemic control, addressing insulin resistance through weight loss, controlling atherosclerosis through anti-inflammatory effects and cardio-renal-neuro protection, makes GLP-1RAs a suitable therapeutic strategy on long-term treatment of T2DM. This review discusses the role of GLP-1RAs in diabetes, the dosage, mono or combination therapy with other antidiabetics in long-term treatment and its effect in uncontrolled diabetes.
Export Options
About this article
Cite this article as:
Sivakumar Malliappan Ponnurengam , Premkumar B. *, Prabhawathi Veluchamy and Prabhakar Kumar Pranav *, Role of GLP-1 Analogs in the Management of Diabetes and its Secondary Complication, Mini-Reviews in Medicinal Chemistry 2021; 21 (20) . https://dx.doi.org/10.2174/1389557521666210422114909
DOI https://dx.doi.org/10.2174/1389557521666210422114909 |
Print ISSN 1389-5575 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5607 |
![](/images/wayfinder.jpg)
- Author Guidelines
- Bentham Author Support Services (BASS)
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Small RNAs Play Big Roles: MicroRNAs in Diabetic Wound Healing
Current Molecular Medicine Direct Renin Inhibition: Promising Treatment in Renoprotection?
Recent Patents on Cardiovascular Drug Discovery Curcumin, Hesperidin, and Rutin Selectively Interfere with Apoptosis Signaling and Attenuate Streptozotocin-Induced Oxidative Stress- Mediated Hyperglycemia
Current Neurovascular Research Arterial Stiffness and Type 1 Diabetes: The Current State of Knowledge
Current Diabetes Reviews Role of AGEs-RAGE System in Cardiovascular Disease
Current Pharmaceutical Design Omega-3 and Renal Function in Older Adults
Current Pharmaceutical Design Stem Cell-Based Immunomodulation in Type 1 Diabetes: Beyond the Regenerative Approach
Current Pharmaceutical Design The Diabetic Charcot Foot
Current Diabetes Reviews The role of NADPH Oxidase in Vascular Disease – Hypertension, Atherosclerosis & Stroke
Current Pharmaceutical Design Can Probiotics Supplementation Improve Glycemic and Renal Status in Diabetic Nephropathy? A Systematic Review and Meta-Analysis of Clinical Trials
Endocrine, Metabolic & Immune Disorders - Drug Targets Physical Activity and Diabetic Cardiomyopathy: Myocardial Adaptation Depending on Exercise Load
Current Diabetes Reviews The ONTARGET Trial Programme: Facts and Lessons
Current Hypertension Reviews Effects of Antioxidant Polyphenols on TNF-Alpha-Related Diseases
Current Topics in Medicinal Chemistry Role of Hydrogen Sulfide and Polysulfides in Neurological Diseases: Focus on Protein S-Persulfidation
Current Neuropharmacology Bioorganic Compounds Produced by the Fungus Monascus and their Use in Health Sciences and Medicine
Mini-Reviews in Organic Chemistry Triptolide Improves Renal Injury in Diabetic Nephropathy Rats through TGF-β1/Smads Signal Pathway
Endocrine, Metabolic & Immune Disorders - Drug Targets Application of Pharmacogenomic Approaches in the Study of Drug Response in Complex Diseases
Current Pharmacogenomics The Interaction Between Gender and Diabetes Mellitus in the Coronary Heart Disease Risk
Current Pharmaceutical Design Pharmacological and Non Pharmacological Strategies in the Management of Coronary Artery Disease and Chronic Kidney Disease
Current Cardiology Reviews Subject Index To Volume 3
Vascular Disease Prevention (Discontinued)