Abstract
The parallel rise in the prevalence of obesity and T2DM is a global health challenge. One of the pathogenesis involved in development and progression of type-2 diabetes mellitus is beta cell dysfunction. Until now, diabetes treatments could not restore the reduced function of pancreatic β cell, necessitating the need for advanced treatment options. This led to discovery of incretin hormones in the small intestine, which stimulates insulin secretion in response to glucose. Glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are two such incretin hormones, secreted by the small intestine in response to food ingestion. Important physiological effects of GLP-1 include enhancement of the insulinotropic response of beta cells to intake of nutrients, reduced gastrointestinal secretion and motility, as well as induction of satiety and ensuing reduction of food intake.
Recent evidence suggests that in addition to its established glucose-lowering actions, GLP-1 RAs may also exert several beneficial actions extending beyond glycemic control. The recent finding that GIP/GLP-1 receptor co-agonists like tirzepatide have superior efficacy compared to selective GLP-1 receptor agonists with respect to glycaemic control as well as body weight has renewed interest in GIP, which previously was thought to lack therapeutic potential.
This is a narrative review examining some of the ‘beyond-glycemic” benefits of incretin hormones, focusing predominantly on GLP-1 RAs including blood pressure lowering, improvements in the lipid profile, improvements in myocardial and endothelial function. We explore how those effects may help reduce the cardiovascular burden in patients with diabetes. The aim is to encourage use of GLP-1 RA early in patients with established CVD risk factors to prevent CVD related complications and mortality.
Keywords: glucagon-like peptide-1 receptor agonist, cardiovascular diseases, major adverse cardiovascular events, type 2 diabetes mellitus, obesity, GIP receptor.
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Corresponding Author
Fatma Abubakar Amin
Primary Health Care Headquarters, Doha, Qatar
DOI: https://dx.doi.org/10.18535/jmscr/v12i09.04
