The Mechanism of Metabolic Influences on the Endogenous GLP-1 by Oral Antidiabetic Medications in Type 2 Diabetes Mellitus

Abstract EN

Incretin-based therapy is now a prevalent treatment option for patients with type 2 diabetes mellitus (T2DM).

It has been associated with considerably good results in the management of hyperglycemia with cardiac or nephron-benefits.

For this reason, it is recommended for individuals with cardiovascular diseases in many clinical guidelines.

As an incretin hormone, glucagon-like peptide-1 (GLP-1) possesses multiple metabolic benefits such as optimizing energy usage, maintaining body weight, β cell preservation, and suppressing neurodegeneration.

However, recent studies indicate that oral antidiabetic medications interact with endogenous or exogenous GLP-1.

Since these drugs are transported to distal intestine portions, there are concerns whether these oral drugs directly stimulate intestinal L cells which release GLP-1, or whether they do so via indirect inhibition of the activity of dipeptidyl peptidase-IV (DPP-IV).

In this review, we discuss the metabolic relationships between oral antihyperglycemic drugs from the aspect of gut, microbiota, hormones, β cell function, central nervous system, and other cellular mechanisms.