One benefit of GLP-1 receptor agonists is that they do not cause hypoglycemia when combined with metformin or thiazolidinediones, but the dose of concomitant sulphonylurea or insulin may have to be decreased to reduce the risk of hypoglycemic episodes.
Why GLP-1 does not cause hypoglycemia?
It increases insulin secretion while inhibiting glucagon release, but only when glucose levels are elevated (6,10), thus offering the potential to lower plasma glucose while reducing the likelihood of hypoglycemia. Furthermore, gastric emptying is delayed (10) and food intake is decreased after GLP-1 administration.
What effect does GLP-1 have on blood glucose concentrations?
Clinical studies demonstrate that the blood glucose-lowering action of GLP-1 is itself glucose-dependent. More specifically, GLP-1 reduces levels of blood glucose only when concentrations of blood glucose are elevated above fasting levels, as is the case after a meal.
What is a possible serious adverse effect of GLP-1 agonist therapy?
GLP-1 receptor agonists can cause nausea, vomiting, diarrhea, headache, weakness, or dizziness. Some side effects are warning signs of serious conditions. For example, nausea and vomiting with abdominal pain could be pancreatitis (inflammation of the pancreas).
Which drug does not cause hypoglycemia?
Metformin given in combination with a sulfonylurea lowers blood glucose concentrations more than either drug alone. In addition to causing modest weight loss, metformin has two other advantages as compared with sulfonylureas. They are: It is less likely to cause hypoglycemia.
Do SGLT2 inhibitors cause hypoglycemia?
SGLT2 inhibitors only lower plasma glucose levels by blocking reabsorption of filtered glucose, which falls as plasma levels fall. Thus, they do not usually cause hypoglycemia in the absence of therapies that otherwise cause hypoglycemia. SGLT2 inhibitors modestly decrease blood pressure and weight .
Who should not take GLP-1?
Therefore, some GLP-1 agonists are strictly contraindicated in patients with MEN syndrome type 2 or personal or family history of thyroid cancer, as these conditions can increase the risk of developing thyroid carcinomas. Furthermore, GLP-1 agonists have not been studied in patients with a history of pancreatitis.
How does GLP-1 affect insulin?
In the central nervous system, GLP-1 induces satiety, leading to reduced weight gain. In the pancreas, GLP-1 is now known to induce expansion of insulin-secreting β-cell mass, in addition to its most well-characterized effect: the augmentation of glucose-stimulated insulin secretion.
How does GLP-1 increase insulin resistance?
In conclusion, our results indicated that GLP-1 improved inflammatory macrophage-derived insulin resistance by inhibiting NF-κB pathway and secretion of inflammatory cytokines in macrophages.
What do GLP-1 receptor agonists do?
The GLP-1RAs have been shown to significantly improve glycemic parameters and reduce body weight. These agents work by activating GLP-1 receptors in the pancreas, which leads to enhanced insulin release and reduced glucagon release-responses that are both glucose-dependent-with a consequent low risk for hypoglycemia.
What are the side effects of Meglitinides?
The most frequent adverse effect of meglitinides is hypoglycemia. The overall incidence of hypoglycemia with repaglinide is similar to that reported with sulfonylureas, but the incidence of serious hypoglycemia is lower. Other adverse effects are respiratory tract infections and headache.
Do DPP 4 inhibitors cause hypoglycemia?
GLP-1-based therapies, including the DPP-4 inhibitors, do not usually cause hypoglycemia unless combined with therapies that can cause hypoglycemia .
What are the most common side effects of SGLT2 inhibitors?
Common SGLT2 side effects include:
- Urinary tract infection.
- Female and male genital yeast infections.
- Upper respiratory tract infections.
- Increased urination.
- Dyslipidemia (increase in cholesterol)
- Joint pain.
Which oral antidiabetic drugs cause hypoglycemia?
Patients on sulfonylureas and meglitinides have the highest incidence of hypoglycemia because of their pharmacological action of increasing insulin secretion. Of the sulfonylureas, glyburide presents the highest risk of hypoglycemia.
What drug interacts with oral hypoglycemic agents?
|Table 4 Potential interactions between sulfonylureas or repaglinide and drugs which alter hepatic enzymes|
|Inducers of metabolism (reduce concentration of hypoglycaemic drug)||Inhibitors of metabolism (increase concentration of hypoglycaemic drug)|
Does biguanides cause hypoglycemia?
Biguanides do not affect the output of insulin; unlike other hypoglycemic agents such as sulfonylureas and meglitinides. They do not cause hypoglycemia per se.