Managing insulin resistance: the forgotten pathophysiological component of type 2 diabetes.
| Autor: | Abdul-Ghani M; Diabetes Division, UT Health, San Antonio, TX, USA., Maffei P; University of Padova, Padova, Italy., DeFronzo RA; Diabetes Division, UT Health, San Antonio, TX, USA. Electronic address: defronzo@uthscsa.edu. |
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| Jazyk: | angličtina |
| Zdroj: | The lancet. Diabetes & endocrinology [Lancet Diabetes Endocrinol] 2024 Sep; Vol. 12 (9), pp. 674-680. Date of Electronic Publication: 2024 Aug 01. |
| DOI: | 10.1016/S2213-8587(24)00127-X |
| Abstrakt: | Glucagon-like peptide-1 (GLP-1) receptor agonists have gained widespread use in the treatment of individuals with type 2 diabetes because of their potent weight loss promoting effect, ability to augment β-cell function, and cardiovascular protective effects. However, despite causing impressive weight loss, GLP-1 receptor agonists do not normalise insulin sensitivity in people with type 2 diabetes and obesity, and the long-term effects of this class of antidiabetic medication on muscle mass, frailty, and bone density have been poorly studied. Although GLP-1 receptor agonists improve insulin sensitivity secondary to weight loss, the only true direct insulin-sensitising drugs are thiazolidinediones. Because of side-effects associated with type 2 diabetes therapy, these drugs have not gained widespread use. In lieu of the important role of insulin resistance in the cause of type 2 diabetes and in the pathogenesis of atherosclerotic cardiovascular disease in type 2 diabetes, development of potent insulin-sensitising drugs that can be used in combination with GLP-1 receptor agonists remains a large unmet need in the management of individuals with type 2 diabetes. Competing Interests: Declaration of interests RAD is on advisory boards for AstraZeneca, Novo Nordisk, Boehringer Ingelheim, Intarcia, Aardvark, Renalytix, CORCEPT, and Alnylam; has received research grants from Boehringer Ingelheim, AstraZeneca, 89Bio, Amgen, Medality, and CORCEPT; and is a member of speakers bureaus for AstraZeneca, CORCEPT, and Renalytix. All other authors declare no competing interests. (Copyright © 2024 Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.) |
| Databáze: | MEDLINE |
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