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Role of GLP-1 Analogs in The Management of Diabetes and Its Secondary Complication

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Pranav Kumar Prabhakar
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Role of GLP-1 Analogs in The Management of Diabetes and Its Secondary Complication

Scopus

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Pranav Kumar Prabhakar
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Mini reviews in medicinal chemistry • Volume 21, Issue 20, Pages 3166 - 3182 • 2021

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10.2174/1389557521666210422114909

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Role of GLP-1 Analogs in the Management of


Diabetes and its Secondary Complication
Sivakumar P.M.a, Premkumar B.b, Prabhawathi V.c, Prabhakar P.K.d
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a
Center for Molecular Biology, Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam
b
Department of Pharmacology, K. K College of Pharmacy, Chennai, Tamil Nadu, India
c
Multidisciplinary Research Unit, Coimbatore Medical College Hospital, Coimbatore , 641014, Tamil Nadu, India
d
Department of Medical Laboratory Sciences, Lovely Professional University, 144411, Punjab, India

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Abstract
The cardiovascular complications of Type 2 Diabetes Mellitus (T2DM) including myocardial infarction,
heart failure, peripheral vascular disease and, stroke and retinopathy, nephropathy and neuropathy are
microvascular complications. While the newer therapies like glitazones or even Dipeptidyl- peptidase-
IV (DPP-IV) inhibitors increase the risk of therapy, the Glucagon Like Peptide-1 Receptor Agonists (GLP-
1RAs), were reported as suitable alternates. The GLP-1RAs reduce Major Adverse Cardiovascular Events
(MACE), have anti-atherogenic potential, and possess pleiotropic activity. The GLP-1RAs were found to
improve neuroprotection, enhance neuronal growth, reduce the incidence of stroke, and improve
central insulin resistance. The GLP-1RAs are beneficial in improving the glycemic profile, preventing
macroalbuminuria and reducing the decline in eGFR and enhancing renal protection. The renal benefits
of add-on therapy of GLP-1RAs with SGLT-2 inhibitors have composite renal outcomes such as
suppression of inflammatory pathways, improvement in natriuresis, diuresis, found to be
nephroprotective. Improvement in glycemic control with a reduction in body weight and
intraglomerular pressure and prevention of tubular injury makes the GLP-1RAs as suitable add-on
therapies in improving cardiorenal outcomes. Obesity, an important contributor to insulin resistance
and a reduction in weight, is an essential therapeutic option in addressing diabetic-obesity. It also
reduces the damage to blood-retinal-barrier, thus beneficial in halting the development of diabetic
retinopathy. In diabetic complications, glycemic control, addressing insulin resistance through weight
loss, controlling atherosclerosis through anti-inflammatory effects and cardio-renal-neuro protection,
makes GLP-1RAs a suitable therapeutic strategy on long-term treatment of T2DM. This review
discusses the role of GLP-1RAs in diabetes, the dosage, mono or combination therapy with other
antidiabetics in long-term treatment and its effect in uncontrolled diabetes. Copyright© Bentham
Science Publishers; For any queries, please email at [email protected].

Author keywords
diabetes; dipeptidyl-peptidase; Glucagon like peptide-1; microvascular complications.;
neuropathy; retinopathy

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© This record is sourced from MEDLINE/PubMed, a database of the U.S. National


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