Importance of prevention in Diabetes Mellitus and the Role of incretin in Pharmacotherapy of diabetes mellitus type II
Absztrakt
Type 2 Diabetes mellitus is a metabolic disorder that consists of an array of malfunctions characterized by high level of blood sugar, which results in combination of resistance to insulin action, inadequate insulin secretion and excessive or inappropriate glucagon secretion. People with type 2 diabetes require regular monitoring and ongoing treatment to maintain normal or near normal blood sugar levels. Treatment includes lifestyle adjustments, self-care measures, and medications, which can minimize the risk of diabetes related and cardiovascular complications (eg, heart attacks and strokes). Learning to manage diabetes is a process that continues over a lifetime. The diagnosis of diabetes can be overwhelming at the beginning; however, most people are able to lead normal lives and many patients become experts in their own care. Objectives: prevalence and burden of diabetes mellitus is rapidly increasing and its estimated that more than 552 million will be suffering from this condition by the year 2030. The importance of preventive methods in reducing this number or at least delaying its occurrence are under focus of different health organizations and governments and it is recommended that a lifestyle modification methods such as diet modification, weight loss, and physical activity of at least 30 min per day for 5 times a week should be purposed for all age groups. Cessation of smoking behavior and alcohol consumption should be recommended as well. Two relatively new groups of drugs were introduced: 1) Glucagon like peptide 1 agonists (GLP-1) and 2) Dipeptidyl peptidase IV inhibitors (DPP IV), for the treatment of type 2 DM. GLP-1 agonists mimic the endogenous incretin by stimulating glucose dependent insulin release as well as reduce glucagon and slows down gastric emptying. On the other side DPP IV inhibitors prolong the action of incretin hormones, which then inhibit glucagon release and follows by increase insulin secretion and decrease gastric emptying.