[ Diabetes Type 1 ]

Cardiovascular Actions of Incretin-Based Therapies

LT Davison: On March 14, 2013 the FDA issued a Drug Safety Communication informing the public that it is evaluating unpublished new findings by a group of academic researchers that suggest an increased risk of pancreatitis, or inflammation of the pancreas, and pre-cancerous cellular changes called pancreatic duct metaplasia in patients with type 2 diabetes treated with a class of drugs called incretin mimetics. Improved understanding of the physiology underlying incretins has led to the development of new therapies that act through modulation of the incretin system. The revised algorithm accounts for the entry of incretin-based therapies into common clinical practice, especially where control of body weight and hypoglycemia are concerns. We included two groups exposed to maternal diabetes in utero: offspring of women with diet-treated gestational diabetes mellitus (O-GDM; n = 163) or type 1 diabetes (O-T1DM; n = 146). These drugs work by mimicking the incretin hormones that the body usually produces naturally to stimulate the release of insulin in response to a meal. In 519 participants, a hyperinsulinemic-euglycemic clamp was performed, in 314 participants an intravenous glucose tolerance test (IVGTT), and in 102 subjects a hyperglycemic clamp combined with GLP-1 and arginine stimuli. The MarketScan database contains claims data for employees or retirees and their dependents who are covered by health insurance plans sponsored by large U.S.

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