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Item
#10
Another
Treatment Option Glucagon-like Peptide 1 (GLP-1) Looking Good
May
turn out to be beneficial for the treatment of type 2 diabetes.
A
study involving continuous administration of GLP-1 to type 2
diabetics, undertaken by Dr Jens Juul Holst, Department of Medical
Physiology, The University of Copenhagen, Copenhagen, Denmark, is
showing positive results after 6 weeks of therapy.
Type 2 diabetes affects an estimated 10 percent of adults over 60
years of age and is now being diagnosed in teenagers as well.
Treatment normally includes alteration to diet, exercise, oral
hypoglycemic agents, and -- if needed - insulin.
Clinicians point out that in type 2 diabetes, strict glycemic
control reduces the risk of micro-vascular complications, but the
deterioration of b-cell function seems inevitable.
Glucagon-like peptide 1 (GLP-1) is an intestinally produced
peptide hormone secreted in response to intake of food and has an
important role in regulating postprandial blood glucose
concentrations. It has been proposed as a treatment for type 2
diabetes.
Dr Holst and colleagues recruited 20 patients with type 2 diabetes
and assigned 10 to receive continuous subcutaneous infusion of
GLP-1, and 10 to receive saline for six weeks. Assessments
including b-cell function, measurement of blood glucose
concentration, insulin sensitivity, and ratings of appetite, were
recorded at baseline, one and six weeks.
The clinicians found that in the GLP-1 group, fasting and
eight-hour average blood glucose decreased by 4.3 mmol/L (77mg/Dl)
and 5.5 mmol/L (99mg/Dl) respectively. Bodyweight decreased by 1.9
kg, and appetite was reduced. Both insulin sensitivity and b-cell
function improved, and there were no reported side-effects.
Dr Holst notes that the study has some methodological constraints:
it was not randomized, nor double blind, "and such
observational studies can overestimate intervention effects
compared with randomized trials."
On the other hand, patients were similar at entry, which minimizes
selection bias; most outcome measures were biochemical analyses,
and several were analyzed independently from the investigators;
and the patients were masked to the intervention.
The researchers said that the pilot study indicates that a GLP-1
based treatment is likely to be effective in the long-term.
They add that "some sort of failure might have been expected,
because treatment is based on an exaggerated supply of one of the
natural factors of blood-glucose regulation. The improved insulin
sensitivity, b-cell function, body weight and free-fatty-acid
levels during treatment could not have been predicted, and
probably reflect the profound improvement of metabolic regulation
occurring during treatment."
Dr Holst concludes: "Our hope is that this new treatment, in
addition to effectively correcting the metabolic disturbances of
the disease, may actually help restore the underlying defective
b-cell function." Lancet
2002; 359: 824-30
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Did
you know?
The
fatter you are the sooner you die according to the CDC.
So when you go to buy a belt, make sure you measure your
Life Size
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