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Investigational agents that protect pancreatic islet β-cells from failure
journal contribution
posted on 2005-10-01, 00:00 authored by Kathryn Aston-MourneyKathryn Aston-Mourney, J Proietto, S AndrikopoulosType 2 diabetes is associated with insulin resistance and reduced insulin secretion, which results in hyperglycaemia. This can then lead to diabetic complications such as retinopathy, neuropathy, nephropathy and cardiovascular disease. Although insulin resistance may be present earlier in the progression of the disease, it is now generally accepted that it is the deterioration in insulin-secretory function that leads to hyperglycaemia. This reduction in insulin secretion in Type 2 diabetes is due to both islet β-cell dysfunction and death. Therefore, interventions that maintain the normal function and protect the pancreatic islet β-cells from death are crucial in the treatment of Type 2 diabetes so that plasma glucose levels may be maintained within the normal range. Recently, a number of compounds have been shown to protect β-cells from failure. This review examines the evidence that the existing therapies for Type 2 diabetes that were developed to lower plasma glucose (metformin) or improve insulin sensitivity (thiazolidinediones) may also have islet-protective function. Newer emerging therapeutic agents that are designed to increase the levels of glucagon-like peptide-1 not only stimulate insulin secretion but also appear to increase islet β-cell mass. Evidence will also be presented that the future of drug therapy designed to prevent β-cell failure should target the formation of advanced glycation end products and alleviate oxidative and endoplasmic reticulum stress.
History
Journal
Expert opinion on investigational drugsVolume
14Issue
10Pagination
1241 - 1250Publisher
Informa HealthcareLocation
England, LondonPublisher DOI
ISSN
1744-7658eISSN
1354-3784Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2005, Ashley Publications Ltd.Usage metrics
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advanced glycation end-productsapoptosisendoplasmic reticulum stressislet dysfunctionmetforminoxidative stressrenin–angiotensin systemthiazolidinedionesScience & TechnologyLife Sciences & BiomedicinePharmacology & Pharmacyrenin-angiotensin systemGLUCAGON-LIKE PEPTIDE-1ENDOPLASMIC-RETICULUM STRESSPULSATILE INSULIN-SECRETIONTYPE-2 DIABETES-MELLITUSGLYCATION END-PRODUCTSGENE PROMOTER ACTIVITYFREE FATTY-ACIDSGLUCOSE TOXICITY
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