Incretin mimetics and enhancers for the treatment of type 2 diabetes mellitus

Abstract

Recently, new therapeutic strategies based on the incretin system have been developed for the treatment of type 2 diabetes mellitus. The present mini-review aims to provide a short overview of the background of this incretin system and the therapeutic potential of incretin mimetics and enhancers (DPP-4 inhibitors). The function of the incretin system, which shows gradual failure in type 2 diabetes, can be restored by incretin mimetics or DPP-4 inhibitors, with subsequently an improve of glycaemic control without an increase of risk for hypoglycaemia, as long as not combined with glucose-lowering agents like sulfonylureas or insulin. Incretin mimetics have additional important weight-reducing properties, though associated with gastro-intestinal adverse events. DPP-4 inhibitors appear to be 'weight neutral' and show a safe profile in a limited number of available clinical studies of short duration.