Téma: Overview works

Inhibitors of dipepeptidyl peptidase 4 (gliptines ) – new pathogenetic approach in therapy with oral antidiabetic drugs

Ivan Tkáč

Insulin secretion deficit and insulin resistance are two basic pathogenetic mechanisms for development of type 2 diabetes mellitus and present therapeutical modalities are based on their affecting. Derivates of sulfonylurea can stimulate insulin secretion independently from food intake. Food intake physiologically provokes secretion of inkretines in the small intestine that are able to stimulate secretion of insulin in β-cells of pancreas, the highest effect of which has glucagon-like peptide 1 (GLP-1). Regarding the short half time of this protein that is degraded by the enzyme dipeptidyl peptidase 4 (DPP-4) two subgroups of drugs have been developed that can after administration increase the incretine effect. Analogues GLP-1 are not degraded DPP-4 and they are used subcutaneously. Inhibitors of DPP-4 (gliptines) can be administered orally. In addition to stimulate secretion of insulin, gliptines are able to inhibit secretion of glucagon. Regarding glucose-dependent stimulation of insulin secretion they do not cause hypoglycaemia, weight gaining and only minimum of adverse effects of the therapy. The first inhibitor of DPP-4 registered in SR is sitagliptine (Januvia, MSD), recommended as additional therapy for patients with insufficiently compensated metformin. In registration and postregistration studies administration of sitagliptine in doses of 100 mg per day lead to mean decreasing of HbA1c about 0,74 % comparing with placebo. The most frequent side effects of the therapy were nasopharyngeal and urinary infections. Gliptines represent a new therapeutical approach in oral antidiabetic therapy with a good tolerance and high safety profile in studies lasting one year.

Ročník 2007  Témy časopisu Internal medicine 7 / 2007

CHAIRMAN OF THE EDITORIAL BOARD
prof. MUDr. Ivica Lazúrová, CSc. FRCP

REPRESENTATIVE OF CHAIRMAN
prof. MUDr. Juraj Payer, CSc., FRCP

MEMBERS OF THE EDITORIAL BOARD
doc. MUDr. Viera Fábryová, CSc.
MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
prof. MUDr. Štefan Hrušovský, CSc. Dr.SVS.
prof. MUDr. Rudolf Hyrdel, CSc.
doc. MUDr. Oľga Jurkovičová, CSc.
doc. MUDr. Zdenko Killinger, PhD.
doc. MUDr. Soňa Kiňová, PhD.
prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
prof. MUDr. Karel Pacák, DrSc.
prof. MUDr. Juraj Payer, CSc., FRCP
doc. MUDr. Ján Podoba, CSc.
prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
prof. MUDr. Ivan Tkáč, PhD.

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Eva Stachová
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DIAGNOSTIC AND THERAPEUTICAL ALGORITHMS
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3. Key words - in the extent of 3-6 (only for overview papers and Appendices - General Medicine). 4. English translation: paper title, summary, key words (only at overview papers, and Appendices - General Medicine)

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6. Bibliography
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Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett ́ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

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b. Scandinavian origin
c. propionibacterium acnes
d. endothelial growth factor


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Due to practical focus of the journal we would like to ask you to write the paper comprehensively, with emphasis on practical use of provided information in out-
patient internists and general practitioners.


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