Type 2 diabetes mellitus is a chronic dysmetabolic condition characterized by hyperglycemia and accompanied by dyslipidemia (low HDL, high triglycerides), and hypertension associated with insulin resistance in obesity. In addition to the glucose-reducing effects, incretin-based therapies have been found to have cardiovascular protective properties. This review summarizes the best available evidence favoring these positive pleiotropic effects of incretin mimetics as well as incretin enhancers.
Studies in animals and humans are accumulating showing the direct as well as indirect actions of the glucagon-like peptide 1 analogues and dipeptidyl peptidase 4 inhibitors on the cardiovascular system. This class of agents appear to have effects on the cardiomyocytes, blood vessels, adipose tissue, regulation of blood pressure, and postprandial intestinal lipoprotein metabolism.
Long-term hard outcome trials are under way that investigate the effects of incretin-based treatments on elevated cardiovascular risks in patients with type 2 diabetes.
aDepartment of Internal Medicine, Medical Center Alkmaar, Alkmaar
bDepartment of Internal Medicine/Endocrinology, VU University Medical Center, Amsterdam
cDepartment of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Correspondence to Dr Suat Simsek, Department of Internal Medicine, Medical Center Alkmaar, PO Box 7057, 1815 JD, Wilhelminalaan 12, Alkmaar, The Netherlands.Tel: +31 72 548 3322; fax: +31 72 548 21 65; e-mail: email@example.com