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The Role of Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes in Asia

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Abstract

The improvement of glycemic control in patients with type 2 diabetes (T2D) is an urgent need in Asia. East Asian T2D patients have distinct characteristics, including relatively low body weight, early impairment of islet beta cell function with reduced insulin secretion and a marked increase in postprandial blood glucose levels. Control of postprandial hyperglycemia and beta cell preservation are key elements of the therapeutic strategy for these patients. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce HbA1c, fasting plasma glucose, and (in particular) postprandial glucose levels, and slow gastric emptying, while minimizing the risk of hypoglycemia and weight gain. Compared with long-acting GLP-1RAs, short-acting GLP-1RAs produce greater slowing of gastric emptying (which is a key factor driving the reduction of postprandial glycemia) and induce beta cell rest rather than promoting postprandial insulin secretion when used under physiological conditions. GLP-1RAs have greater efficacy in Asian than Caucasian patients. GLP-1RA add-on therapy provides clinically meaningful reductions in HbA1c and postprandial glucose in Asians with T2D inadequately controlled by oral antidiabetic drugs (OADs) or basal insulin ± OADs. Premixed insulin is often prescribed for T2D patients in China. A short-acting GLP-1RA plus basal insulin is an alternative to premixed insulin, resulting in better efficacy and a lower risk of hypoglycemia and weight gain. In conclusion, GLP-1RAs, especially short-acting GLP-1RAs, are a practical treatment option for East Asian patients with T2D inadequately controlled by OADs or basal insulin.

Funding: Sanofi.

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Acknowledgements

Funding

This review and the article processing charges were funded by Sanofi. The author had full access to the information used to compile this work and takes complete responsibility for the integrity and accuracy of this review.

Medical Writing and Editorial Assistance

Medical writing and editorial assistance was provided by Kathy Croom and Steve Clissold of Content Ed Net and was funded by Sanofi.

Authorship

The author meets the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article and takes responsibility for the integrity of the work as a whole, and has given his approval for this version to be published.

Disclosures

In addition to this project for Sanofi, Ju-Ming Lu reported receiving consulting fees from Novo Nordisk and lecture fees from Bayer, Merck, and Lilly.

Compliance with Ethics Guidelines

This mini review is based on previously conducted studies and does not contain any studies with human participants or animals performed by the authors.

Data Availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

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  1. Department of Endocrinology, Chinese PLA General Hospital, Beijing, China

    Ju-Ming Lu

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Correspondence to Ju-Ming Lu.

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Cite this article

Lu, JM. The Role of Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes in Asia. Adv Ther 36, 798–805 (2019). https://doi.org/10.1007/s12325-019-00914-9

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