Safety of Incretin-based Therapies for Type 2 Diabetes

Shih-Li Su

《Formosan Journal of Endocrinology and Metabolism》 5卷S期 (2014/05) Pp. 30-34

https://doi.org/10.6856/FJEM.201405_5(S).0005

摘要

Background. Incretins are hormones released from the intestine in response to food, prompting insulin secretion before blood glucose goes up. There are two major incretin hormones: glucose dependent insulinotropic polypeptide and glucagon-like peptide 1 (GLP-1). They are rapidly degraded by dipeptidyl peptidase IV (DPP-IV). Incretin-based therapies for type 2 diabetes are GLP-1 receptor agonists and DPP-IV inhibitors nowadays. Concerns of increased risk of medullary thyroid carcinoma and pancreatic cancer have been raised since these therapies became available in the market. Findings. Studies in rodents have shown C-cell hyperplasia, sometimes resulting in increased incidence of medullary thyroid carcinoma, with GLP-1 agonists. This has raised concern about an increased risk of medullary thyroid carcinoma in humans of using GLP-1 agonists. Increased risk of acute pancreatitis is a potential side effect of both DPP-IV inhibitors and GLP-1 receptor agonists. This has led to speculation that this translates to an increased risk of pancreatic cancer. There are clearly conflicting data that have been presented in preclinical studies and in epidemiologic studies regarding the long-term consequences of using incretin-based therapies Conclusion. There are no clear prospective data at this time on increased cancer risk from incretin-based therapies. There is a need for close surveillance of these agents. We suggest clinicians to follow prescribing guidelines for incretin-based therapies.

關鍵字

dipeptidyl-peptidase IV inhibitors ； drug safety ； glucagon-like peptide 1 ； type 2 diabetes