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1、ThissupplementissponsoredbyPrimaryCareEducationSUPPLEMENTTOConsortiumandthePrimaryCareMetabolicGroupandwasFREEsupportedbyaneducationalgrantbyAmylinPharmaceuticals,1.0CMELLC.IthasbeeneditedandpeerreviewedbyTheJournalofCREDITFamilyPractice.www.pcmg-us.o
2、rgAvailableatjfponline.comVOL62,NO6/JUNE2013IntegratingIncretin-BasedTherapyintoType2DiabetesManagementLEARNINGOBJECTIVESStephenA.Brunton,MD,FAAFP1.ExplaintheconceptoftheincretineffectAdjunctClinicalProfessor,DepartmentofFamilyMedicineanddescribedefec
3、tsinincretinsecretionUniversityofNorthCarolina,ChapelHill,NorthCarolinaandincretinactionthatoccurintype2diabetesmellitus(T2DM)2.Provideanoverviewoftherationaleandnsulinresistanceandpancreaticb-celldysfunctionarewell-roleofincretin-basedtherapyasde-est
4、ablishedasthetwocorepathophysiologicdefectsinpatientswithscribedincurrentpracticeguidelinesforItype2diabetesmellitus(T2DM).In2009,DeFronzo1proposedthat6themanagementofpatientswithT2DMotherdefectsalsocontributetoglucoseintoleranceinT2DM.Amongthis3.Comp
5、aretheefficacy,safety,andtoler-“ominousoctet”ofdefects,theroleoftheincretinhormonesinthegastro-abilityoftheincretin-basedtherapiescur-rentlyavailableintestinalsystemhasbeenincreasinglyrecognized.Knownastheincretin4.Describestrategiestooptimizeincretin
6、-effect,thisphenomenonmayberesponsibleforupto70%ofinsulinsecre-basedtherapytioninresponsetooralglucoseoramealinhealthyindividuals.2Ofthein-cretinhormones,glucagon-likepeptide-1(GLP-1)isparticularlyimportantTARGETAUDIENCEPrimarycarephysiciansandclinici
7、ansaspostprandiallevelsofGLP-1aredecreasedinpatientswithimpairedglu-cosetoleranceorT2DM.3SinceGLP-1affectsglucosehomeostasisbyre-withaninterestindiabetestreatmentandmanagementducingthefastingplasmaglucose(FPG)andpostprandialplasmaglucose(PPG)levels,4p
8、harmacologicagentsthatraisetheleveloractivityofGLP-1SPONSORDISCLOSURESTATEMENThavebeendeveloped.Thisarticlecomparesthe7agentscurrentlyavailableDrStephenBruntondisclosesthatheisontheadvisoryboardsforAbbott,Boehringer-thatactontheincretinsystem,
