Is There a Justification for Classifying GLP-1 Receptor Agonists As Basal and Prandial?

Overview

Journal Diabetol Metab Syndr

Publisher Biomed Central

Specialty Endocrinology

Date 2017 Jan 25

PMID 28115994

Citations 13

Authors

Inka Minambres

Antonio Perez

Affiliations

Soon will be listed here.

Abstract

Several GLP-1 receptor agonists are currently available for treatment of type 2 diabetic patients. Based on their pharmacokinetic/pharmacodynamic profile, these drugs are classified as short-acting GLP-1 receptor agonists (exenatide and lixisenatide) or long-acting GLP-1 receptor agonists (exenatide-LAR, liraglutide, albiglutide, and dulaglutide). In clinical practice, they are also classified as basal or prandial GLP-1 receptor agonists to differentiate between patients who would benefit more from one or another based on characteristics such as previous treatment and the predominance of fasting or postprandial hyperglycemia. In the present article we examine available data on the pharmacokinetic characteristics of the various GLP-1 agonists and compare their effects with respect to the main parameters used to evaluate glycemic control. The article also analyzes whether the differences between the different GLP-1 agonists justify their classification as basal or prandial.

Citing Articles

Unlocking the potential of glucagon-like peptide-1 receptor agonists in revolutionizing type 2 diabetes management: a comprehensive review.

Joshi N, Baloch K, Rukh S, Khan A, Muskan F, Kumari V Ann Med Surg (Lond). 2024; 86(12):7255-7264.

PMID: 39649934 PMC: 11623894. DOI: 10.1097/MS9.0000000000002712.

Obesity Medications and Their Impact on Cardiovascular Health: A Narrative Review.

Islam K, Islam R, Tong V, Shami M, Allen K, Brodtmann J Cureus. 2024; 16(10):e71875.

PMID: 39559664 PMC: 11573306. DOI: 10.7759/cureus.71875.

Real-World Utilization and Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists Dosed Weekly and Daily in Patients with Type 2 Diabetes Mellitus: Results from Retrospective Electronic Medical Records in China.

Ruan Z, Chen X, Song M, Jia R, Luo H, Ung C Diabetes Metab Syndr Obes. 2024; 17:3657-3666.

PMID: 39386037 PMC: 11463179. DOI: 10.2147/DMSO.S483065.

New Mechanisms to Prevent Heart Failure with Preserved Ejection Fraction Using Glucagon-like Peptide-1 Receptor Agonism (GLP-1 RA) in Metabolic Syndrome and in Type 2 Diabetes: A Review.

Jalil J, Gabrielli L, Ocaranza M, MacNab P, Fernandez R, Grassi B Int J Mol Sci. 2024; 25(8).

PMID: 38673991 PMC: 11049921. DOI: 10.3390/ijms25084407.

Glucometabolic outcomes of GLP-1 receptor agonist-based therapies in patients with type 2 diabetes: a systematic review and network meta-analysis.

Caruso I, Di Gioia L, Di Molfetta S, Cignarelli A, Palmer S, Natale P EClinicalMedicine. 2023; 64:102181.

PMID: 37719418 PMC: 10500557. DOI: 10.1016/j.eclinm.2023.102181.

References

Diamant M, Nauck M, Shaginian R, Malone J, Cleall S, Reaney M . Glucagon-like peptide 1 receptor agonist or bolus insulin with optimized basal insulin in type 2 diabetes. Diabetes Care. 2014; 37(10):2763-73. DOI: 10.2337/dc14-0876. View

Fineman M, Bicsak T, Shen L, Taylor K, Gaines E, Varns A . Effect on glycemic control of exenatide (synthetic exendin-4) additive to existing metformin and/or sulfonylurea treatment in patients with type 2 diabetes. Diabetes Care. 2003; 26(8):2370-7. DOI: 10.2337/diacare.26.8.2370. View

Reusch J, Stewart M, Perkins C, Cirkel D, Ye J, Perry C . Efficacy and safety of once-weekly glucagon-like peptide 1 receptor agonist albiglutide (HARMONY 1 trial): 52-week primary endpoint results from a randomized, double-blind, placebo-controlled trial in patients with type 2 diabetes mellitus not.... Diabetes Obes Metab. 2014; 16(12):1257-64. DOI: 10.1111/dom.12382. View

Perfetti R . Combining basal insulin analogs with glucagon-like peptide-1 mimetics. Diabetes Technol Ther. 2011; 13(9):873-81. PMC: 3160265. DOI: 10.1089/dia.2010.0250. View

Lorenz M, Pfeiffer C, Steinstrasser A, Becker R, Rutten H, Ruus P . Effects of lixisenatide once daily on gastric emptying in type 2 diabetes--relationship to postprandial glycemia. Regul Pept. 2013; 185:1-8. DOI: 10.1016/j.regpep.2013.04.001. View

Marso S, Daniels G, Brown-Frandsen K, Kristensen P, Mann J, Nauck M . Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016; 375(4):311-22. PMC: 4985288. DOI: 10.1056/NEJMoa1603827. View

Kieffer T, McIntosh C, PEDERSON R . Degradation of glucose-dependent insulinotropic polypeptide and truncated glucagon-like peptide 1 in vitro and in vivo by dipeptidyl peptidase IV. Endocrinology. 1995; 136(8):3585-96. DOI: 10.1210/endo.136.8.7628397. View

Buse J, Nauck M, Forst T, Sheu W, Shenouda S, Heilmann C . Exenatide once weekly versus liraglutide once daily in patients with type 2 diabetes (DURATION-6): a randomised, open-label study. Lancet. 2012; 381(9861):117-24. DOI: 10.1016/S0140-6736(12)61267-7. View

Riddle M, Umpierrez G, Digenio A, Zhou R, Rosenstock J . Contributions of basal and postprandial hyperglycemia over a wide range of A1C levels before and after treatment intensification in type 2 diabetes. Diabetes Care. 2011; 34(12):2508-14. PMC: 3220846. DOI: 10.2337/dc11-0632. View

10.

Kim D, MacConell L, Zhuang D, Kothare P, Trautmann M, Fineman M . Effects of once-weekly dosing of a long-acting release formulation of exenatide on glucose control and body weight in subjects with type 2 diabetes. Diabetes Care. 2007; 30(6):1487-93. DOI: 10.2337/dc06-2375. View

11.

Wysham C, Blevins T, Arakaki R, Colon G, Garcia P, Atisso C . Efficacy and safety of dulaglutide added onto pioglitazone and metformin versus exenatide in type 2 diabetes in a randomized controlled trial (AWARD-1). Diabetes Care. 2014; 37(8):2159-67. DOI: 10.2337/dc13-2760. View

12.

Buse J, Bergenstal R, Glass L, Heilmann C, Lewis M, Kwan A . Use of twice-daily exenatide in Basal insulin-treated patients with type 2 diabetes: a randomized, controlled trial. Ann Intern Med. 2010; 154(2):103-12. DOI: 10.7326/0003-4819-154-2-201101180-00300. View

13.

Nauck M, Heimesaat M, Behle K, Holst J, Nauck M, Ritzel R . Effects of glucagon-like peptide 1 on counterregulatory hormone responses, cognitive functions, and insulin secretion during hyperinsulinemic, stepped hypoglycemic clamp experiments in healthy volunteers. J Clin Endocrinol Metab. 2002; 87(3):1239-46. DOI: 10.1210/jcem.87.3.8355. View

14.

Ahren B, Johnson S, Stewart M, Cirkel D, Yang F, Perry C . HARMONY 3: 104-week randomized, double-blind, placebo- and active-controlled trial assessing the efficacy and safety of albiglutide compared with placebo, sitagliptin, and glimepiride in patients with type 2 diabetes taking metformin. Diabetes Care. 2014; 37(8):2141-8. DOI: 10.2337/dc14-0024. View

15.

Berlie H, Hurren K, Pinelli N . Glucagon-like peptide-1 receptor agonists as add-on therapy to basal insulin in patients with type 2 diabetes: a systematic review. Diabetes Metab Syndr Obes. 2012; 5:165-74. PMC: 3402010. DOI: 10.2147/DMSO.S27528. View

16.

Inzucchi S, Bergenstal R, Buse J, Diamant M, Ferrannini E, Nauck M . Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2012; 55(6):1577-96. DOI: 10.1007/s00125-012-2534-0. View

17.

DeFronzo R . Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009; 58(4):773-95. PMC: 2661582. DOI: 10.2337/db09-9028. View

18.

Blevins T, Pullman J, Malloy J, Yan P, Taylor K, Schulteis C . DURATION-5: exenatide once weekly resulted in greater improvements in glycemic control compared with exenatide twice daily in patients with type 2 diabetes. J Clin Endocrinol Metab. 2011; 96(5):1301-10. DOI: 10.1210/jc.2010-2081. View

19.

Riddle M, Aronson R, Home P, Marre M, Niemoeller E, Miossec P . Adding once-daily lixisenatide for type 2 diabetes inadequately controlled by established basal insulin: a 24-week, randomized, placebo-controlled comparison (GetGoal-L). Diabetes Care. 2013; 36(9):2489-96. PMC: 3747925. DOI: 10.2337/dc12-2454. View

20.

Hanefeld M, Koehler C, Hoffmann C, Wilhelm K, Kamke W, Gerstein H . Effect of targeting normal fasting glucose levels with basal insulin glargine on glycaemic variability and risk of hypoglycaemia: a randomized, controlled study in patients with early Type 2 diabetes. Diabet Med. 2010; 27(2):175-80. DOI: 10.1111/j.1464-5491.2009.02915.x. View