Contemporary Updates on the Physiology of Glucagon like Peptide-1 and Its Agonist to Treat Type 2 Diabetes Mellitus

Pathogenesis of diabetes mellitus involves scores of different factors, out of which Glucagon like factor-1 (GLP-1) plays a foremost role. GLP-1 is a peptide-hormone of the incretin system. It exhibits glucagonostatic as well as glucose dependent insulinotropic action. GLP-1 augments regeneration of β-cell, boost secretion of insulin and trim down weight gain in type-2 diabetes. GLP-1 discharge from the L cells of intestine is mediated by neural and hormonal factors which are stimulated by the occurrence of nutrients in the gastrointestinal tract. Conversely, GLP-1 is instantaneously shattered by enzyme dipeptidyl peptidase-IV. GLP-1 is also cleared by renal clearance. Diminished GLP-1 leads to attenuated insulin release leading to type-2 diabetes. Substitution of GLP-1 regularizes the insulin release and prevents type-2 diabetes. However, GLP-1 holding infinitesimal plasma half life limits its therapeutic effects. To surmount the limitations of indigenous GLP-1, several GLP-1 receptor agonist like Exenatide are been developed. Modifications in pharmaceutical formulation are also been made to meet the patients adherence to the medication of GLP-1 agonist. Graphic Abstract: [Figure not available: see fulltext.] © 2019, Springer Nature B.V.