Nanjing, China

Author Affiliations: Department of Pediatric Endocrinology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China (Yu BS, Wang AR)

Corresponding Author: Bao-Sheng Yu, Department of Pediatric Endocrinology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China  (Tel: 86-25-83062672; Fax: 86-25-58509994; Email: drbsyu@yahoo.com.cn)

Background: Incidence of type 2 diabetes mellitus (T2DM) has increased in young people in recent years and new therapies are required for its effective treatment. Glucagon-like peptide 1 (GLP-1) is a potent blood glucose-lowering hormone produced in the L cells of the intestine. It may be potentially effective in the treatment of hyperglycemia in patients with T2DM. 

Data sources: PubMed database were searched with the terms "GLP-1", "incretins" and "diabetes".

Results: GLP-1 is a product of the glucagon gene, and its secretion is controlled by both neural and endocrine signals. GLP-1 lowers plasma glucose by stimulating insulin and suppressing secretion of glucagons, thus inhibiting gastric emptying and reducing appetite. GLP-1 exerts these actions by the engagement of structurally distinct G-protein-coupled receptors (GPCRs). In patients with T2DM, GLP-1 increases insulin secretion and normalizes both fasting and postprandial blood glucose when given as a continuous intravenous infusion. However, the native hormone is unsuitable as a drug because it is broken down rapidly by dipeptidyl peptidase IV (DPP-4) and cleared by the kidneys. Fortunately, many GLP-1 agonists or analogues and DPP-4 inhibitors have been found or developed, such as exendin-4, exenatide, liraglutide, CJC1131, vidaliptin and P32/98. Clinical trials have shown their therapeutic functions in T2DM with little adverse reaction.

Conclusion: A GLP-1 based therapy will be safe and effective for the treatment of T2DM.

Key words: glucagon-like peptide 1; incretins; type 2 diabetes mellitus

                   World J Pediatr 2008;4(1):8-13