Time for testing incretin therapies in early type 1 diabetes?

Abstract

Incretin-based compounds, including glucagon-like peptide-1 receptor agonists and dipeptidylpeptidase-4 inhibitors, have emerged as a new class of agents for the treatment of type 2 diabetes. In this article, the potentialandsupporting evidence for extending their use to early type 1 diabetes are reviewed. The rationale relies on the assumption that these drugs, in addition to their action on insulin secretion and glucose regulation, maybe effective in preserving and even expanding the β-cell mass. This assumption is based on data from in vitro and animal studies, with no clear demonstrations in humans. This class of drugs may represent an entirely new approach to the treatment of type 1 diabetes, focused on protection and preservation of β-cells, an ideal complement to immune interventions inhibiting or modulating the pathogenetic autoimmune process. The ideal candidates for this treatment are patients at the time of clinical onset of type 1 diabetes or individuals with preclinical type 1 diabetes who still have a significant viable β-cell mass. Copyright © 2010 by The Endocrine Society.